Healthcare Provider Details

I. General information

NPI: 1932153335
Provider Name (Legal Business Name): CENTURY AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 GREELAND AVE
JACKSONVILLE FL
32221-4404
US

IV. Provider business mailing address

740 GREELAND AVE
JACKSONVILLE FL
32221-4404
US

V. Phone/Fax

Practice location:
  • Phone: 904-356-0835
  • Fax: 904-356-9677
Mailing address:
  • Phone: 904-356-0835
  • Fax: 904-356-9677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number002566
License Number StateFL

VIII. Authorized Official

Name: JUSTIN MEISER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 330-217-2652