Exeter District Ambulance
Organization Active NPI Ambulance · Exeter, CA
NPI 1033127014 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1033127014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- AMB05007 (CA)
- Legal business name
- EXETER DISTRICT AMBULANCE
- Practice address
- 302 East Palm Street
Exeter, CA 93221 - Phone
- (559) 594-5250
- Fax
- (559) 592-2301
- NPI assigned
- Aug 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lori J Trowbridge
- Title
- Operations Manager
- Phone
- (559) 594-5250
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050719001292 | CA | Part B Supplier - Ambulance Service Supplier | 9234166430 | Practice locations: Exeter, CA |
National Provider Directory
Locations
302 E Palm St
Exeter, CA 93221
Phone (209) 594-5250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | AMB05007 | CA | Yes |
Addresses
Primary practice location
302 East Palm Street
Exeter, CA 93221
Mailing address
302 East Palm Street
Exeter, CA 93221
Phone (559) 594-5250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MTE00289F | Medicaid | CA |
Other providers in Exeter, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.