MEDICARE: KEY LARGO VOLUNTEER AMBULANCE CORP 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

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	:	1639178791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEY LARGO VOLUNTEER AMBULANCE CORP INC

Provider Business Mailing Address
First Line	:	PO BOX 5847
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-0847
Country	:	US
Telephone Number	:	877-288-8561
Fax Number	:	770-297-0550

Provider Business Practice Location Address
First Line	:	98600 OVERSEAS HWY
Second Line	:
City	:	KEY LARGO
State	:	FL
Zip	:	33037
Country	:	US
Telephone Number	:	305-451-2766
Fax Number	:	305-451-1562

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	HOLLY HIRNEISEN
Credential	:
Telephone Number	:	770-297-0440

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	09/06/2023

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Directions to “KEY LARGO VOLUNTEER AMBULANCE CORP INC ” Practice Location

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