LIBERTY AMBULANCE SERVICE INC NPI 1407850159

NPI Information

NPI: 1407850159
Provider Name: LIBERTY AMBULANCE SERVICE INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 10D1019768

Address:
1626 ATLANTIC UNIVERSITY CIR
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 805-0293
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LIBERTY AMBULANCE SERVICE INC is a land transport ambulance in Jacksonville, FL. LIBERTY AMBULANCE SERVICE INC NPI is 1407850159. The provider is registered as an organization entity type.

The provider's business location address is:

1626 ATLANTIC UNIVERSITY CIR
JACKSONVILLE, FL
ZIP 32207-227
Phone: (904) 805-0293
Fax: (904) 724-0226

The provider's authorized official is Michael A Assaf .
The authorized official title is President and has the following contact phone number (904) 721-0008.

The CLIA number assigned to this NPI record is 10D1019768 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2005 and was last updated on 5/12/2011.

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	002470	FLORIDA	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	099501100	MEDICAID	FLORIDA
2	A0554	MEDICARE PIN	FLORIDA

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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