County of Grand

Organization Active NPI Land Ambulance · Granby, CO

NPI 1790760361 · NPPES record last updated Oct 13, 2023

Key facts

NPI
1790760361
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
Legal business name
COUNTY OF GRAND
Practice address
81 W Agate Avenue
Granby, CO 80446-1457
Phone
(970) 887-2732
Fax
(970) 887-1698
NPI assigned
Dec 7, 2005
Organization subpart
No

Authorized official

Name
Mr. Edward T Moyer
Title
County Manager
Phone
(970) 725-3101

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2020469Grand County EMS
81 West Agate Ave, Granby, CO 80446
Certificate of waiverFeb 17, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070511000076 CO Part B Supplier - Ambulance Service Supplier 0345346102 Practice locations: Granby, CO

National Provider Directory

Tax ID family
County of Grand (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X CO Yes

Addresses

Primary practice location

81 W Agate Avenue
Granby, CO 80446-1457

Mailing address

P.O. Box 1457
Granby, CO 80446-1457
Phone (970) 887-2732

Other identifiers

IdentifierTypeStateIssuer
00619837MedicaidCO

Other names

  • GRAND COUNTY EMERGENCY MEDICAL SERVICES Doing business as

Other providers in Granby, CO

All providers in Granby, CO · Land Ambulance in Colorado

Sources for this page

Verify at the official NPI Registry.