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General NPI Number Information
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NPI Number | 1306896790
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Entity Type | Organization
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Legal Business Name | RANDLE EASTERN AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 12600 NW 107TH AVE
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City | MEDLEY
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State | FL
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Zip | 33178-3121
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Country | US
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Telephone | 305-718-6400
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Fax | 305-640-1557
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Provider Business Mailing Address
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Address Line | PO BOX 402079
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City | ATLANTA
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State | GA
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Zip | 30384-2079
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Country | US
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Telephone | 800-913-9106
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | TIMOTHY JOSEPH DORN
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Credential |
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Telephone | 833-703-2294
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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