Healthcare Provider Details

I. General information

NPI: 1962628305
Provider Name (Legal Business Name): EMERGENCY MEDICAL SERVICES SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3627 KILAUEA AVE
HONOLULU HI
96816-2317
US

IV. Provider business mailing address

PO BOX 269110
SACRAMENTO CA
95826-9110
US

V. Phone/Fax

Practice location:
  • Phone: 808-733-8329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA ROSEN
Title or Position: PROGRAM MANAGER
Credential:
Phone: 808-733-8329