TRI VALLEY AMBULANCE SERVICE INC NPI 1982757282

Ambulance (Land Transport) in Wellton, AZ

NPI 1982757282 Organization Ambulance Land Transport

About TRI VALLEY AMBULANCE SERVICE INC

Tri Valley Ambulance Service Inc is a provider established in Wellton, Arizona specializing in ambulance (land transport) . The NPI number of Tri Valley Ambulance Service Inc is 1982757282 and was assigned on January 2007. The practitioner's primary taxonomy code is 3416L0300X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Gerard A Masse Cep (Director Of Operations)

NPI

1982757282

Provider NameTRI VALLEY AMBULANCE SERVICE INC
Provider Location Address29118 LOS ANGELES AVE WELLTON, AZ 85356
Provider Mailing AddressPO BOX 958 WELLTON, AZ 85356
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-19-2007
Last Update Date06-03-2008


Primary Taxonomy

Taxonomy Code3416L0300X
ClassificationAmbulance
TypeTransportation Services
SpecializationLand Transport
License StateAZ

Business Address

TRI VALLEY AMBULANCE SERVICE INC
29118 LOS ANGELES AVE
WELLTON, AZ
ZIP 85356
Phone: (928) 785-9019
Fax: (928) 785-3624

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Mailing Address

TRI VALLEY AMBULANCE SERVICE INC
PO BOX 958
WELLTON, AZ
ZIP 85356
Phone: (928) 785-9019
Fax: (928) 785-3624



Authorized Official

Authorized Official Name GERARD A MASSE CEP
Authorized Official TitleDIRECTOR OF OPERATIONS
Authorized Official Phone(928) 785-9019

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
070805OTHER (01)AZ
0000RFBCFCMEDICARE ID-TYPE UNSPECIFIED (04)AZ
070805-001OTHER (01)AZ

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.