American Legion Post No. 108 Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

AMERICAN LEGION POST NO. 108 AMBULANCE SERVICE

Doing business as

American Legion Ambulance

Practice address

11350 American Legion Dr
Jackson, CA 95642-9764

Phone

(209) 223-2963

Fax

(209) 267-5463

NPI assigned

Jul 28, 2005

Last updated

May 19, 2026By 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

Mrs. Michelle Tyer

Title

President, Ceo

Phone

(209) 223-2963

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• American Legion Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1609876929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 AMERICAN LEGION DR",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429764",
            "telephone_number": "209-223-2963",
            "fax_number": "209-267-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 AMERICAN LEGION DR",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429764",
            "telephone_number": "209-223-2963",
            "fax_number": "209-267-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN LEGION POST NO. 108 AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "TYER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "209-223-2963",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00749F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "590480356",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Legion Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "American Legion Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Jackson, CA
• Providers in Jackson, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.