Organization Active NPI

Ambulance Service, Inc.

  • Land Ambulance
  • Jacksonville, FL
National Provider Identifier
1679662886
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1602 Issued in FL
Legal business name
AMBULANCE SERVICE, INC.
Practice address
5995 Philips Hwy
Jacksonville, FL 32216-5916
Phone
(904) 733-6600
Fax
(904) 899-9024
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Kathy S Wallace
Title
President
Phone
(904) 733-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1602 FL Primary

Addresses

Primary practice location

5995 Philips Hwy
Jacksonville, FL 32216-5916

Mailing address

5995 Philips Hwy
Jacksonville, FL 32216-5916
Phone (904) 733-6600

Other identifiers 1

IdentifierTypeStateIssuer
08813400MedicaidFL

National Provider Directory

National Provider Directory

Locations

5025 Stepp Ave
Jacksonville, FL 32216
Phone (904) 733-6602

5995 Philips Hwy
Jacksonville, FL 32216
Phone (904) 733-6600

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679662886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 PHILIPS HWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165916",
            "telephone_number": "904-733-6600",
            "fax_number": "904-899-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 PHILIPS HWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165916",
            "telephone_number": "904-733-6600",
            "fax_number": "904-899-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-733-6600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "FL",
            "license": "1602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08813400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.