Healthcare Provider Details
I. General information
NPI: 1447884507
Provider Name (Legal Business Name): ALLIANCE AMBULANCE OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2020
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3118 E MCDOWELL RD
PHOENIX AZ
85008-3742
US
IV. Provider business mailing address
PO BOX 847102
DALLAS TX
75284-7102
US
V. Phone/Fax
- Phone: 602-231-0090
- Fax:
- Phone: 800-913-9106
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
SCOTT
TIERNEY
Title or Position: EVP, CHIEF FINANCIAL OFFICER
Credential:
Phone: 833-703-2294