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General NPI Number Information
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NPI Number | 1760501969
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Entity Type | Organization
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Legal Business Name | STAT AMBULANCE INC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 1704 CENTRAL AVE
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City | COLUMBUS
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State | IN
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Zip | 47201-5326
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Country | US
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Telephone | 812-379-9111
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Fax | 812-379-9539
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Provider Business Mailing Address
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Address Line | 1704 CENTRAL AVE
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City | COLUMBUS
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State | IN
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Zip | 47201-5326
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Country | US
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Telephone | 812-379-9111
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Fax | 812-379-9539
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. ANDREW JASON VEST
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Credential |
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Telephone | 812-379-9111
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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 | 29203-A
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License Number State | IN
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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 | 0541
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License Number State | IN
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