City of Springdale

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

139 Issued in AR

Legal business name

CITY OF SPRINGDALE

Doing business as

Springdale Ambulance Division

Practice address

417 Holcomb St
Springdale, AR 72764-5322

Phone

(479) 751-4510

NPI assigned

Jun 29, 2006

Last updated

Oct 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael J Irwin

Title

Fire Chief

Phone

(479) 751-4510

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Springdale Ambulance Division Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1346278348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 HOLCOMB ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645322",
            "telephone_number": "479-751-4510",
            "fax_number": "479-750-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 HOLCOMB ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645322",
            "telephone_number": "479-751-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SPRINGDALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "IRWIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "479-751-4510"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106302715",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springdale Ambulance Division",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Springdale Ambulance Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vania Stefany Cienfuegs Aguilar
• Kathryn Cingolani, LPN
• Circle of Life (Circle of Life Hospice)
• Circle of Life Palliative Care LLC
• Circle of Life Personal Care LLC
• City Pharmacy of Springdale Inc (City Pharmacy)
• Kortney D Clamucha, LAC
• Christopher Robin Clark, M.D.
• Eleasha Clark, COTA
• Erin Clark, MHPP

• Land Ambulance in Springdale, AR
• Providers in Springdale, AR by specialty
• Land Ambulance in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.