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General NPI Number Information
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NPI Number | 1760745343
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Entity Type | Organization
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Legal Business Name | FRONTIER AMBULANCE SERVICE TRANSPORTS
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 410 CRYSTAL AVE.
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City | GOLDFIELD
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State | NV
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Zip | 89013
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Country | US
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Telephone | 775-910-3635
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 667
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City | TONOPAH
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State | NV
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Zip | 89049-0667
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Country | US
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Telephone | 775-910-3635
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | ASHLEY NICOLE BERRY
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Credential |
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Telephone | 775-910-3635
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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 |
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License Number State | NV
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