1588652325 NPI number — DEL NORTE COMMUNITY AMBULANCE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588652325 NPI number — DEL NORTE COMMUNITY AMBULANCE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEL NORTE COMMUNITY AMBULANCE, 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:
Provider Other Organization Name Type Code:
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:
1588652325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PADUCAH
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42002-9150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-744-8413
Provider Business Mailing Address Fax Number:
270-744-8642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
560 PINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEL NORTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81132-2243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-580-0763
Provider Business Practice Location Address Fax Number:
719-657-2456
Provider Enumeration Date:
10/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
CARLA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
719-580-0763

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: 9000157782 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 709855500 . This is a "DOL - FECA / BL / ENERGY" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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