Provider Demographics
NPI:1174543771
Name:CLEVELAND COUNTY AMBULANCE SERVICE
Entity type:Organization
Organization Name:CLEVELAND COUNTY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:870-325-6700
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:RISON
Mailing Address - State:AR
Mailing Address - Zip Code:71665-0562
Mailing Address - Country:US
Mailing Address - Phone:870-325-6700
Mailing Address - Fax:870-325-7750
Practice Address - Street 1:601 SYCAMORE
Practice Address - Street 2:
Practice Address - City:RISON
Practice Address - State:AR
Practice Address - Zip Code:71665
Practice Address - Country:US
Practice Address - Phone:870-325-6700
Practice Address - Fax:870-325-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR490341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE0880OtherAHIN PROVIDER #
ARE0880OtherAHIN PROVIDER #