Provider Demographics
NPI:1366541310
Name:PAFFORD EMERGENCY MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:PAFFORD EMERGENCY MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-451-8036
Mailing Address - Street 1:PO BOX 1120
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71802-1120
Mailing Address - Country:US
Mailing Address - Phone:800-451-8036
Mailing Address - Fax:870-777-8479
Practice Address - Street 1:1300 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2924
Practice Address - Country:US
Practice Address - Phone:800-451-8036
Practice Address - Fax:870-777-8479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1558176Medicaid
AR176987715Medicaid
LAF3900OtherBCBS OF LOUISANA
LAF3900OtherBCBS OF LOUISANA
590013539Medicare ID - Type UnspecifiedRAILROAD MEDICARE