Healthcare Provider Details

I. General information

NPI: 1700819695
Provider Name (Legal Business Name): PHYSICIANS & SURGEONS AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8261 STATE ROUTE 235
DAYTON OH
45424-6383
US

IV. Provider business mailing address

PO BOX 100217
ATLANTA GA
30384-0217
US

V. Phone/Fax

Practice location:
  • Phone: 937-543-6881
  • Fax:
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: TIMOTHY JOSEPH DORN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 833-703-2294