McCloud Community Services District
Organization Active NPI Land Ambulance · McCloud, CA
NPI 1992859052 · NPPES record last updated Feb 16, 2012
Key facts
- NPI
- 1992859052
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- MCCLOUD COMMUNITY SERVICES DISTRICT
- Practice address
- 220 W. Minnesota Ave
McCloud, CA 96057 - Phone
- (530) 964-2017
- Fax
- (530) 964-3175
- NPI assigned
- Jan 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Emily Coulter
- Title
- Finance Officer
- Phone
- (530) 964-2017
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110621000120 | CA | Part B Supplier - Ambulance Service Supplier | 8527246669 | Practice locations: McCloud, CA |
National Provider Directory
Locations
220 W Minnesota Ave
McCloud, CA 96057
Phone (530) 964-2017
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
220 W. Minnesota Ave
McCloud, CA 96057
Mailing address
PO Box 269110
Sacramento, CA 95826-9110
Phone (916) 669-4607
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ74472Z | Medicaid | CA |
Other providers in McCloud, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.