Healthcare Provider Details

I. General information

NPI: 1639172596
Provider Name (Legal Business Name): ALLIED AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 MAIN ST
MEDFORD MA
02155-6160
US

IV. Provider business mailing address

308 MAIN ST
MEDFORD MA
02155-6160
US

V. Phone/Fax

Practice location:
  • Phone: 781-498-9400
  • Fax: 781-498-9404
Mailing address:
  • Phone: 781-498-9400
  • Fax: 781-498-9404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY F QUILL
Title or Position: PRESIDENT
Credential:
Phone: 781-844-7874