PROGRESSIVE AMBULANCE INC. NPI 1962576660

NPI Information

NPI: 1962576660
Provider Name: PROGRESSIVE AMBULANCE, INC.

Doing Business As: LIBERTY AMBULANCE

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
350 E RIDGECREST BLVD
RIDGECREST, CA
ZIP 93555
Phone: (760) 375-6531
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PROGRESSIVE AMBULANCE, INC. is a land transport ambulance in Ridgecrest, CA. PROGRESSIVE AMBULANCE, INC. NPI is 1962576660. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Ambulance.

The provider's business location address is:

350 E RIDGECREST BLVD
RIDGECREST, CA
ZIP 93555-928
Phone: (760) 375-6531
Fax: (760) 371-1115

The provider's authorized official is James A Suver .
The authorized official title is Ceo and has the following contact phone number (760) 499-3902.

The CLIA number assigned to this NPI record is 05D0683704 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 4/25/2023.

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	1799	CALIFORNIA	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	MTE00293F	MEDICAID	CALIFORNIA

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: 4/28/2024

NPI Synchronization or Removal

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