=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255646980
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPHAONE AMBULANCE MEDICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2010
-----------------------------------------------------
Last Update Date | 01/18/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10461 OLD PLACERVILLE RD STE 110&120
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95827-2522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-635-2011
-----------------------------------------------------
Fax | 916-851-0939
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10461 OLD PLACERVILLE ROAD STE 110
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95827-2508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-635-2011
-----------------------------------------------------
Fax | 916-254-5109
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PRESIDENT
-----------------------------------------------------
Name | THOMAS ARJIL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 916-635-2011
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------