1659350874 NPI number — URGENT AMBULANCE SERVICE INC

Table of content: (NPI 1659350874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659350874 NPI number — URGENT AMBULANCE SERVICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URGENT AMBULANCE SERVICE 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:
1659350874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3348
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPARTANBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29304-3348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-764-4911
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 TYLER WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-3449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-452-4443
Provider Business Practice Location Address Fax Number:
302-454-1837
Provider Enumeration Date:
01/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MACCHIONE
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-452-4443

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: AM19 . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0000751915 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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