Healthcare Provider Details

I. General information

NPI: 1124020607
Provider Name (Legal Business Name): MONROVIA ARCADIA AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2005
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E FOOTHILL BLVD
MONROVIA CA
91016-2250
US

IV. Provider business mailing address

230 E FOOTHILL BLVD
MONROVIA CA
91016-2250
US

V. Phone/Fax

Practice location:
  • Phone: 626-256-9386
  • Fax: 626-359-9271
Mailing address:
  • Phone: 626-256-9386
  • Fax: 626-359-9271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberBUS2005-00182
License Number StateCA

VIII. Authorized Official

Name: MR. TIMOTHY RUSSELL COCHREN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 626-256-9386