Happy Camp Volunteer Ambulance Service, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

HAPPY CAMP VOLUNTEER AMBULANCE SERVICE, INC

Practice address

38 Park Way
Happy Camp, CA 96039

Phone

(530) 493-2643

NPI assigned

Jun 17, 2005

Last updated

Dec 17, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kirk Andrew Eadie

Title

EMS Manager

Phone

(530) 493-2643

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1013912781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "HAPPY CAMP",
            "state": "CA",
            "postal_code": "960390596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 PARK WAY",
            "city": "HAPPY CAMP",
            "state": "CA",
            "postal_code": "96039",
            "telephone_number": "530-493-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAPPY CAMP VOLUNTEER AMBULANCE SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "EADIE",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "EMS MANAGER",
        "authorized_official_telephone_number": "530-493-2643"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00466F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thanh Tat DO, D.D.S.
• David Eisenberg, RN
• Alvin Ray Guy
• Happy Camp Community Action, Inc.
• Happy Camp Union Elementary School District
• Patricia Louise Hobbs
• Nicole Hokanson, RDH
• Karuk Tribe (Karuk Community Health Clinic)
• Charles Sidney Lent, MSW, LCSW
• Janis Pia Madkins, DDS

• Land Ambulance in Happy Camp, CA
• Providers in Happy Camp, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.