MEDICARE: MEDICWEST AMBULANCE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance
2	341600000X	Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003006180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICWEST AMBULANCE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 745774
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90074-5774
Country	:	US
Telephone Number	:	800-913-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 MITCHELL ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2707
Country	:	US
Telephone Number	:	702-650-9900
Fax Number	:	702-650-3300

Authorized Official
Title or Position	:	EVP, CHIEF FINANCIAL OFFICER
Name	:	BRIAN SCOTT TIERNEY
Credential	:
Telephone Number	:	833-703-2294

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	03/19/2026

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Language	Start Address	Practice Location

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