=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760587604
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICARE ALS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11301 E US HIGHWAY 92
-----------------------------------------------------
City | SEFFNER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33584-3350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-930-0911
-----------------------------------------------------
Fax | 813-936-8341
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11301 E US HIGHWAY 92
-----------------------------------------------------
City | SEFFNER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33584-3350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-930-0911
-----------------------------------------------------
Fax | 813-936-8341
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF FINANCE
-----------------------------------------------------
Name | MR. DANIEL W SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-930-0911
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 2612
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------