NPIMap

Organization Active NPI

Trinity County Life Support

  • Land Ambulance
  • Weaverville, CA
National Provider Identifier
1417013616
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1574 Issued in CA
Legal business name
TRINITY COUNTY LIFE SUPPORT
Practice address
610 Washington St.
Weaverville, CA 96093
Phone
(530) 623-2500
Fax
(530) 623-2614
NPI assigned
Dec 29, 2006
Last updated
Oct 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Authorized official

Name
Kathleen Ratliff
Title
Administrator
Phone
(530) 623-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1574 CA Primary

Addresses

Primary practice location

610 Washington St.
Weaverville, CA 96093

Mailing address

PO Box 496084
Redding, CA 96049-6084
Phone (530) 241-0473

Other identifiers 1

IdentifierTypeStateIssuer
MTE00685FMedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1417013616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-241-0473",
            "fax_number": "530-241-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WASHINGTON ST.",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "96093",
            "telephone_number": "530-623-2500",
            "fax_number": "530-623-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY COUNTY LIFE SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "RATLIFF",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "530-623-2500"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CA",
            "license": "1574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00685F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weaverville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.