Provider Demographics
NPI:1215989207
Name:WES MCCABE
Entity type:Organization
Organization Name:WES MCCABE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:MCCABE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-PARAMEDIC
Authorized Official - Phone:479-471-5750
Mailing Address - Street 1:6337 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-8482
Mailing Address - Country:US
Mailing Address - Phone:479-471-5750
Mailing Address - Fax:479-471-0237
Practice Address - Street 1:6337 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-8482
Practice Address - Country:US
Practice Address - Phone:479-471-5750
Practice Address - Fax:479-471-0237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00371638Medicare PIN
AR47397Medicare PIN