Organization Active NPI

Northshore EMS LLC

  • Land Ambulance
  • Bogalusa, LA
National Provider Identifier
1114952751
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
9110086 Issued in LA
Legal business name
NORTHSHORE EMS LLC
Practice address
153 Montgomery St
Bogalusa, LA 70427-3925
Phone
(985) 735-5907
Fax
(985) 735-5916
NPI assigned
Jul 12, 2006
Last updated
Nov 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Authorized official

Name
Mr. Bernard Brennan Jr.
Title
Owner
Phone
(985) 735-5907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 9110086 LA Primary

Addresses

Primary practice location

153 Montgomery St
Bogalusa, LA 70427-3925

Mailing address

153 Montgomery St
Bogalusa, LA 70427-3925
Phone (985) 735-5907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040830000352 LA Part B Supplier - Ambulance Service Supplier 7618942087 Practice locations: Bogalusa, LA

National Provider Directory

National Provider Directory
Tax ID family
Northshore EMS LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

153 Montgomery St
Bogalusa, LA 70427
Phone (985) 735-5907

1005 15th Ave
Franklinton, LA 70438

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1114952751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 MONTGOMERY ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273925",
            "telephone_number": "985-735-5907",
            "fax_number": "985-735-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 MONTGOMERY ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273925",
            "telephone_number": "985-735-5907",
            "fax_number": "985-735-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-735-5907",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "LA",
            "license": "9110086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.