MEDICARE: ANTELOPE AMBULANCE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	1834	CA
2	341600000X	Ambulance	1834	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326045949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTELOPE AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	P.O. BOX 5480
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93539-5480
Country	:	US
Telephone Number	:	661-951-1998
Fax Number	:	661-951-1188

Provider Business Practice Location Address
First Line	:	42540 N. 6TH STREET EAST
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-5202
Country	:	US
Telephone Number	:	661-951-1998
Fax Number	:	661-951-1188

Authorized Official
Title or Position	:	CORPORATE SECRETARY
Name	:	MR. DOUGLAS RICHARD CAIN
Credential	:
Telephone Number	:	661-951-1998

Provider Enumeration Date	:	06/29/2005
Last Update Date	:	02/01/2018

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Directions to “ANTELOPE AMBULANCE SERVICE ” Practice Location

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