1477621514 NPI number — AMCARE MEDICAL SYSTEMS, INC.

Table of content: (NPI 1477621514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477621514 NPI number — AMCARE MEDICAL SYSTEMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMCARE MEDICAL SYSTEMS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMCARE AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477621514
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3108 LORD BALTIMORE DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDSOR MILL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21244-5807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-753-1835
Provider Business Mailing Address Fax Number:
410-753-1838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
256 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT ALBANS
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05478-1866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-527-1244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROSENBERG
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-753-1831

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0009380 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".