Healthcare Provider Details

I. General information

NPI: 1679573232
Provider Name (Legal Business Name): INTERCITY AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 DOUGLAS AVE
PROVIDENCE RI
02908-2542
US

IV. Provider business mailing address

457 DOUGLAS AVE
PROVIDENCE RI
02908-2542
US

V. Phone/Fax

Practice location:
  • Phone: 401-273-8020
  • Fax: 401-454-0763
Mailing address:
  • Phone: 401-273-8020
  • Fax: 401-454-0763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ALFRED U BARBERY JR.
Title or Position: PRESIDENT
Credential:
Phone: 401-273-8020