Organization Active NPI

Medic Ambulance Service Inc

  • Ambulance
  • Vallejo, CA
National Provider Identifier
1871527887
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
MEDIC AMBULANCE SERVICE INC
Practice address
506 Couch St
Vallejo, CA 94590
Phone
(707) 644-1771
Fax
(707) 644-1784
NPI assigned
Jul 10, 2006
Last updated
Aug 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Authorized official

Name
Mrs. Helen Frances Pierson
Title
Cfo
Phone
(916) 564-9040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X CA Primary

Addresses

Primary practice location

506 Couch St
Vallejo, CA 94590

Mailing address

1001 Texas St Ste C
Fairfield, CA 94533-5723
Phone (916) 564-9040

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ81763ZMedicaidCA
MTE00865FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120410000237 CA Part B Supplier - Ambulance Service Supplier 1951348002 Practice locations: Sacramento, CA; Vallejo, CA

National Provider Directory

National Provider Directory

Locations

1001 Texas St
Ste C
Fairfield, CA 94533

2349 Lexington St
Sacramento, CA 95815
Phone (916) 564-9040

506 Couch St
Vallejo, CA 94590
Phone (707) 644-1761

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1871527887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 TEXAS ST STE C",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335723",
            "telephone_number": "916-564-9040",
            "fax_number": "916-564-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 COUCH ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94590",
            "telephone_number": "707-644-1771",
            "fax_number": "707-644-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "PIERSON",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "916-564-9040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ81763Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00865F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.