Organization Active NPI

Columbia County Ambulance Service Co Inc

  • Land Ambulance
  • Magnolia, AR
National Provider Identifier
1053361295
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
590 Issued in AR
Legal business name
COLUMBIA COUNTY AMBULANCE SERVICE CO INC
Practice address
218 S Pine
Magnolia, AR 71753-3642
Phone
(870) 234-7371
Fax
(870) 234-2992
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Mr. Amanda NewtonNPI 1316802127
Title
Owner
Phone
(870) 234-7371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 590 AR Primary
Land Ambulance 3416L0300X 576 AR

Addresses

Primary practice location

218 S Pine
Magnolia, AR 71753-3642

Mailing address

218 S Pine
Magnolia, AR 71753-3642
Phone (870) 234-7371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121112000110 AR Part B Supplier - Ambulance Service Supplier 5799936142 Practice locations: Magnolia, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2198232Columbia County Ambulance Service218 S Pine Street, Magnolia, AR 71753Certificate of waiverOct 29, 2026

National Provider Directory

National Provider Directory

Locations

218 S Pine
Magnolia, AR 71753
Phone (501) 234-7371

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1053361295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 S PINE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533642",
            "telephone_number": "870-234-7371",
            "fax_number": "870-234-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S PINE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533642",
            "telephone_number": "870-234-7371",
            "fax_number": "870-234-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA COUNTY AMBULANCE SERVICE CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-234-7371",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "590",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.