Sam'S Ambulette Service, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

05087 Issued in WA

Legal business name

SAM'S AMBULETTE SERVICE, LLC

Practice address

25611 16TH Ave S
Des Moines, WA 98198-8953

Phone

(253) 249-8300

Fax

(206) 429-3122

NPI assigned

Feb 25, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Ismael Tabalno

Title

Member/Manager

Phone

(253) 249-8300

Specialties & licenses 1

Addresses

Other names 1

• SAS Cabulance Other name

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1306143342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98724",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981980724",
            "telephone_number": "253-249-8300",
            "fax_number": "206-429-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25611 16TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981988953",
            "telephone_number": "253-249-8300",
            "fax_number": "206-429-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S AMBULETTE SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "TABALNO",
        "authorized_official_first_name": "ISMAEL",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "253-249-8300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WA",
            "license": "05087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAS Cabulance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Non-emergency Medical Transport (VAN) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.