| NPI | 1073713137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS L PRUITT Captain 276-226-0409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 341600000X Ambulance |
| Additional Taxonomies | 341600000X Ambulance (Licence: VA 331) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2016-10-08 |