Provider Demographics
NPI:1447295803
Name:ATMORE AMBULANCE, INC.
Entity type:Organization
Organization Name:ATMORE AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STILL
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:251-368-3003
Mailing Address - Street 1:121 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-2445
Mailing Address - Country:US
Mailing Address - Phone:251-368-3003
Mailing Address - Fax:251-368-2517
Practice Address - Street 1:121 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-2445
Practice Address - Country:US
Practice Address - Phone:251-368-3003
Practice Address - Fax:251-368-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1253416L0300X
FL0025403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL52754OtherBLUE CROSS BLUE SHIELD