City of Etna
Organization Active NPI Land Ambulance · Etna, CA
NPI 1124024070 · NPPES record last updated Oct 18, 2016
Key facts
- NPI
- 1124024070
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- CITY OF ETNA
- Practice address
- 442 Main St
Etna, CA 96027 - Phone
- (530) 467-3217
- NPI assigned
- Jun 24, 2005
- Organization subpart
- No
Authorized official
- Name
- Sarah Griggs
- Title
- City Clerk
- Phone
- (530) 467-3217
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120312000222 | CA | Part B Supplier - Ambulance Service Supplier | 1759540750 | Practice locations: Etna, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
442 Main St
Etna, CA 96027
Mailing address
PO Box 269110
Sacramento, CA 95826-9110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ35540Z | Medicaid | CA | |
| 590480415 | Other | RRB |
Other names
- City of Etna Ambulance
Other providers in Etna, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2016. 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.