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General NPI Number Information
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NPI Number | 1568711299
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Entity Type | Organization
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Legal Business Name | RG AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 4227 SAINT LUCIE BLVD
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City | FORT PIERCE
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State | FL
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Zip | 34946-9000
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Country | US
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Telephone | 888-876-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 2766 NW 62ND ST
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City | MIAMI
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State | FL
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Zip | 33147-7662
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Country | US
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Telephone | 772-465-1111
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Fax | 772-466-1150
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES MAYMON
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Credential |
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Telephone | 888-876-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 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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