Citywide Ambulance, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2014-013 Issued in CO

Legal business name

CITYWIDE AMBULANCE, LLC

Practice address

4740 Forge Rd Ste 110
Colorado Springs, CO 80907-3558

Phone

(720) 220-1377

Fax

(303) 671-0237

NPI assigned

Mar 9, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Boris Smoroda

Title

Manager

Phone

(720) 220-1377

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1396138798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19573 E IDA PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800155177",
            "telephone_number": "720-220-1377",
            "fax_number": "303-671-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 FORGE RD STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073558",
            "telephone_number": "720-220-1377",
            "fax_number": "303-671-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITYWIDE AMBULANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "SMORODA",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "720-220-1377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CO",
            "license": "2014-013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.