Active NPI
Ajo Ambulance Inc
- Land Ambulance
- Ajo, AZ
National Provider Identifier
1679565642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 101
- Legal business name
- AJO AMBULANCE INC
- Practice address
- 1850 N Ajo Gila BND Hwy
Ajo, AZ 85321-1117 - Phone
- (520) 387-5154
- Fax
- (520) 387-6050
- NPI assigned
- Aug 16, 2005
- Last updated
- Oct 5, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Sara Coyle
- Title
- Office Manager
- Phone
- (520) 387-5154
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 101 | AZ | Primary |
Addresses
Primary practice location
1850 N Ajo Gila BND Hwy
Ajo, AZ 85321-1117
Mailing address
1850 N Ajo Gila Bend Hwy
Ajo, AZ 85321-1117
Phone (520) 387-5154
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008955 | Medicaid | AZ | |
| AZ0151350 | Other | AZ | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130221000053 | AZ | Part B Supplier - Ambulance Service Supplier | 3274657317 | Practice locations: Ajo, AZ |
National Provider Directory
National Provider Directory- Tax ID family
- Ajo Ambulance Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Ajo, AZ
- NPI 1548120066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1349395200000",
"number": "1679565642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 N AJO GILA BEND HWY",
"city": "AJO",
"state": "AZ",
"postal_code": "853211117",
"telephone_number": "520-387-5154",
"fax_number": "520-387-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 N AJO GILA BND HWY",
"city": "AJO",
"state": "AZ",
"postal_code": "853211117",
"telephone_number": "520-387-5154",
"fax_number": "520-387-6050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AJO AMBULANCE INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-16",
"last_updated": "2012-10-05",
"status": "A",
"authorized_official_last_name": "COYLE",
"authorized_official_first_name": "SARA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "520-387-5154",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "AZ",
"license": "101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008955",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0151350",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ajo, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.