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General NPI Number Information
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NPI Number | 1679803134
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Entity Type | Organization
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Legal Business Name | EXPLORER - 1 AMBULANCE SERVICES LLC
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Dates
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Enumeration Date | 01/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 1040 E COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90221-3306
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Country | US
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Telephone | 310-537-3971
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4639
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City | COMPTON
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State | CA
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Zip | 90224-4639
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Country | US
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Telephone | 310-537-3971
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Fax |
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Authorized Official
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Title or Position | CHIEF, EMS OPERATIONS
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Name | MR. TIMOTHY L. LEE II
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Credential | PARAMEDIC
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Telephone | 310-892-6437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number | P20823
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | P20823
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | P20823
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License Number State | CA
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