1649277617 NPI number — TRANS AM AMBULANCE SERVICES, INC.

Table of content: (NPI 1649277617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649277617 NPI number — TRANS AM AMBULANCE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANS AM AMBULANCE SERVICES, 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:
1649277617
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 660886
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75266-0886
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-372-5871
Provider Business Mailing Address Fax Number:
716-372-1856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 N 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLEAN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14760-9549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-372-5871
Provider Business Practice Location Address Fax Number:
716-372-1856
Provider Enumeration Date:
07/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JEWELL
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF REVENUE INTEGRATION OFFICER
Authorized Official Telephone Number:
844-597-4911

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  10251 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X , with the licence number: 32310 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000586002001 . This is a "BLUE CROSS BLUE SHIELD WN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8190081 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00931580 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1011821430001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00011213801 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com