Holbrook EMS Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

HOLBROOK EMS INC.

Practice address

30 W Vista Dr
Holbrook, AZ 86025-1840

Phone

(928) 524-2190

Fax

(928) 524-1477

NPI assigned

Jun 25, 2006

Last updated

Jan 19, 2012By 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

Tim Hawman

Title

President/Manager

Phone

(928) 524-2190

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1780610063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W VISTA DR",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251840",
            "telephone_number": "928-524-2190",
            "fax_number": "928-524-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W VISTA DR",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251840",
            "telephone_number": "928-524-2190",
            "fax_number": "928-524-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROOK EMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "HAWMAN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT/MANAGER",
        "authorized_official_telephone_number": "928-524-2190"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0151060",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Dee Hatfield, RPH
• Mary Ann Henry, PA-C
• Karen Crystal Hernandez
• Gretchen Elizabeth Herndon, MA, LPC
• Jessica Ann Schauer Herrera, CCC-SLP
• Holbrook Senior Citizens Association (Holbrook Extended Care Facility)
• Holbrook Senior Citizens Association
• Holbrook Senior Citizens Association
• Holbrook Unified School District #3
• Holbrook Urgent Care, LLC

• Land Ambulance in Holbrook, AZ
• Providers in Holbrook, AZ by specialty
• Land Ambulance in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.