Healthcare Provider Details

I. General information

NPI: 1003006180
Provider Name (Legal Business Name): MEDICWEST AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 MITCHELL ST
NORTH LAS VEGAS NV
89081-2707
US

IV. Provider business mailing address

PO BOX 745774
LOS ANGELES CA
90074-5774
US

V. Phone/Fax

Practice location:
  • Phone: 702-650-9900
  • Fax: 702-650-3300
Mailing address:
  • Phone: 800-913-9106
  • Fax:

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 Number
License Number State

VIII. Authorized Official

Name: BRIAN SCOTT TIERNEY
Title or Position: EVP, CHIEF FINANCIAL OFFICER
Credential:
Phone: 833-703-2294