=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861453599
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRELANDS AMBULANCE SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2006
-----------------------------------------------------
Last Update Date | 08/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 JAMES ST
-----------------------------------------------------
City | NEW LONDON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44851-1211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-929-1487
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 JAMES ST
-----------------------------------------------------
City | NEW LONDON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44851-1211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-929-1487
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLERK
-----------------------------------------------------
Name | LUCINDA AMBURGY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 419-929-1487
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------