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General NPI Number Information
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NPI Number | 1881162493
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Entity Type | Organization
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Legal Business Name | BEACON AMBULANCE SERVICES LLC
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 36 ECHO GROVE AVE
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City | LYNN
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State | MA
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Zip | 01905-1967
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Country | US
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Telephone | 781-599-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 36 ECHO GROVE AVE
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City | LYNN
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State | MA
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Zip | 01905-1967
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Country | US
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Telephone | 617-813-1122
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAY PALMER
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Credential |
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Telephone | 212-717-5425
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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 |
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