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General NPI Number Information
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NPI Number | 1265400451
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Entity Type | Organization
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Legal Business Name | PRIDE AMBULANCE COMPANY
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 208 CRUTCHFIELD AVE
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City | NASHVILLE
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State | TN
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Zip | 37210-4710
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Country | US
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Telephone | 615-889-4445
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Fax | 615-884-6980
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Provider Business Mailing Address
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Address Line | 828 PORTAGE ST
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City | KALAMAZOO
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State | MI
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Zip | 49001-3004
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Country | US
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Telephone | 269-343-2224
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Fax | 269-343-6503
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Authorized Official
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Title or Position | COO
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Name | MR. TIM ONDERLINDE
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Credential |
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Telephone | 269-343-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | EMS0000010017
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License Number State | TN
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