Provider Demographics
NPI:1285619742
Name:FAST AMBULANCE SERVICE AND TRANSPORTATION LLC.
Entity type:Organization
Organization Name:FAST AMBULANCE SERVICE AND TRANSPORTATION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:870-853-8016
Mailing Address - Street 1:249 LINDER RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646-9527
Mailing Address - Country:US
Mailing Address - Phone:870-853-8016
Mailing Address - Fax:870-853-9999
Practice Address - Street 1:802 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:AR
Practice Address - Zip Code:71646-3518
Practice Address - Country:US
Practice Address - Phone:870-853-8016
Practice Address - Fax:870-853-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR403146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR158188715Medicaid
AR47396OtherARKANSAS BLUE CROSS
AR47396OtherARKANSAS BLUE CROSS