Provider Demographics
NPI:1871527887
Name:MEDIC AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:MEDIC AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-564-9040
Mailing Address - Street 1:1001 TEXAS ST STE C
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5723
Mailing Address - Country:US
Mailing Address - Phone:916-564-9040
Mailing Address - Fax:916-564-9095
Practice Address - Street 1:506 COUCH ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590
Practice Address - Country:US
Practice Address - Phone:707-644-1771
Practice Address - Fax:707-644-1784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ81763ZMedicaid
CAMTE00865FMedicaid
CAZZZ13187ZMedicare ID - Type Unspecified
CAZZZ81763ZMedicaid