Active NPI
Ambulance Service Inc
- Land Ambulance
- Nezperce, ID
National Provider Identifier
1063451722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 7204
- Legal business name
- AMBULANCE SERVICE INC
- Practice address
- 510 Oak St
Nez Perce, ID 83543 - Phone
- (208) 937-9909
- Fax
- (208) 937-9787
- NPI assigned
- Jun 6, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John R Ungaretti, CCEMTP
- Title
- General Manager
- Phone
- (406) 549-7104
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 7204 | ID | Primary |
Addresses
Primary practice location
510 Oak St
Nez Perce, ID 83543
Mailing address
1008 Burlington Ave Ste C
PO Box 1359
Missoula, MT 59806-1359
Phone (406) 549-7104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050610000790 | ID | Part B Supplier - Ambulance Service Supplier | 4981648946 | Practice locations: Nezperce, ID |
National Provider Directory
National Provider DirectoryLocations
2600 S Garfield St
Missoula, MT 59801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1063451722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 BURLINGTON AVE STE C",
"address_2": "PO BOX 1359",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598061359",
"telephone_number": "406-549-7104",
"fax_number": "406-542-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 OAK ST",
"city": "NEZ PERCE",
"state": "ID",
"postal_code": "83543",
"telephone_number": "208-937-9909",
"fax_number": "208-937-9787"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMBULANCE SERVICE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "UNGARETTI",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "GENERAL MANAGER",
"authorized_official_telephone_number": "406-549-7104",
"authorized_official_credential": "CCEMTP"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "ID",
"license": "7204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nezperce, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.