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General NPI Number Information
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NPI Number | 1518045632
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Entity Type | Organization
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Legal Business Name | MEDCON AMBULANCE
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23000 CONNECTICUT ST #806
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City | HAYWARD
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State | CA
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Zip | 94545-1691
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Country | US
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Telephone | 510-259-1915
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55
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City | WATSONTOWN
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State | PA
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Zip | 17777-0055
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Country | US
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Telephone | 570-538-4488
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Fax | 570-538-1556
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Authorized Official
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Title or Position | CEO
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Name | MR. LEIGHTON S WOOD
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Credential |
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Telephone | 510-259-1915
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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 | 1868
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License Number State | CA
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