MEDICARE: RED LINE AMBULANCE SERVICES, INC.

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	1211	IN

General Provider Information

NPI Number	:	1356723779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED LINE AMBULANCE SERVICES, INC.

Provider Business Mailing Address
First Line	:	774 S STATE ROAD 1
Second Line	:
City	:	CAMBRIDGE CITY
State	:	IN
Zip	:	47327-9472
Country	:	US
Telephone Number	:	765-969-3209
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 S STATE ROAD 1
Second Line	:
City	:	CAMBRIDGE CITY
State	:	IN
Zip	:	47327-9472
Country	:	US
Telephone Number	:	765-969-3209
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	TRAVIS ULERICK
Credential	:
Telephone Number	:	765-969-3209

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	06/22/2015

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Directions to “RED LINE AMBULANCE SERVICES, INC. ” Practice Location

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