Escalon Community Ambulance Inc
Organization Active NPI Ambulance · Escalon, CA
NPI 1134478852 · NPPES record last updated Sep 10, 2012
Key facts
- NPI
- 1134478852
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- ESCALON COMMUNITY AMBULANCE INC
- Practice address
- 1480 Ullrey Ave
Escalon, CA 95320-8612 - Phone
- (209) 838-3264
- NPI assigned
- Sep 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Bob Peterson, M.D.
- Title
- Medical Director
- Phone
- (209) 838-3264
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121012000366 | CA | Part B Supplier - Ambulance Service Supplier | 0941459671 | Practice locations: Escalon, CA |
National Provider Directory
Locations
1480 Ullrey Ave
Escalon, CA 95320
Phone (209) 838-3264
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
1480 Ullrey Ave
Escalon, CA 95320-8612
Mailing address
1480 Ullrey Ave
Escalon, CA 95320-8612
Phone (209) 838-3264
Other providers in Escalon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2012. 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.