Idalia Ambulance Service, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

IDALIA AMBULANCE SERVICE, INC.

Practice address

9141 County Road CC.8
P.O. Box 55
Idalia, CO 80735

Phone

(970) 354-7285

Fax

(970) 354-7285

NPI assigned

Sep 29, 2017

Last updated

Sep 29, 2017By 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

Debra J Moellenberg, EMT-INTERMEDIATE

Title

Director/Authorized Official

Phone

(970) 354-7285

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1649789975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "IDALIA",
            "state": "CO",
            "postal_code": "807350055",
            "telephone_number": "970-354-7285",
            "fax_number": "970-354-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 COUNTY ROAD CC.8",
            "address_2": "P.O. BOX 55",
            "city": "IDALIA",
            "state": "CO",
            "postal_code": "80735",
            "telephone_number": "970-354-7285",
            "fax_number": "970-354-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDALIA AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "MOELLENBERG",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "970-354-7285",
        "authorized_official_credential": "EMT-INTERMEDIATE"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idalia Ambulance Service, Inc.
• Doreen M Pecar, CRNA

• Ambulance in Idalia, CO
• Providers in Idalia, CO by specialty
• Ambulance in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.