Healthcare Provider Details

I. General information

NPI: 1841388857
Provider Name (Legal Business Name): HUGHSON PARAMEDIC AMBULANCE COMPANY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 CHARLES STREET
HUGHSON CA
95326-1719
US

IV. Provider business mailing address

PO BOX 1719
HUGHSON CA
95326-1719
US

V. Phone/Fax

Practice location:
  • Phone: 209-883-9177
  • Fax: 209-883-4178
Mailing address:
  • Phone: 209-883-9177
  • Fax: 209-883-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number103418
License Number StateCA

VIII. Authorized Official

Name: THOMAS CROWDER
Title or Position: CEO
Credential:
Phone: 209-883-9177