Uinta County Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

116 Issued in WY

Legal business name

UINTA COUNTY AMBULANCE SERVICE

Practice address

1136 Front St
Evanston, WY 82930-3370

Phone

(307) 789-8556

Fax

(307) 789-4636

NPI assigned

Nov 13, 2006

Last updated

Aug 22, 2020By 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

Mr. Eric A Quinney

Title

Chief Administrative Officer

Phone

(307) 789-8556

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346311164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829310640",
            "telephone_number": "307-789-8556",
            "fax_number": "307-789-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 FRONT ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303370",
            "telephone_number": "307-789-8556",
            "fax_number": "307-789-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UINTA COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUINNEY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "307-789-8556",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WY",
            "license": "116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD WY",
            "identifier": "7708",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Evanston, WY
• Providers in Evanston, WY by specialty
• Land Ambulance in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.