HOLBROOK EMS INC. NPI 1780610063

NPI Information

NPI: 1780610063
Provider Name: HOLBROOK EMS INC.
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 03D1029374

Address:
30 W VISTA DR
HOLBROOK, AZ
ZIP 86025
Phone: (928) 524-2190
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HOLBROOK EMS INC. is a land transport ambulance in Holbrook, AZ. HOLBROOK EMS INC. NPI is 1780610063. The provider is registered as an organization entity type.

The provider's business location address is:

30 W VISTA DR
HOLBROOK, AZ
ZIP 86025-840
Phone: (928) 524-2190
Fax: (928) 524-1477

The provider's authorized official is Tim Hawman .
The authorized official title is President/manager and has the following contact phone number (928) 524-2190.

The CLIA number assigned to this NPI record is 03D1029374 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 1/19/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Z=========	MEDICARE ID-TYPE UNSPECIFIED	ARIZONA
2	590005381	MEDICARE ID-TYPE UNSPECIFIED		RAILROAD
3	AZ0151060	OTHER	ARIZONA	BLUE CROSS BLUE SHIELD
4	071837	MEDICARE ID-TYPE UNSPECIFIED	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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