HOLBROOK EMS INC. NPI 1780610063

NPI Information

  • NPI: 1780610063
  • Provider Name: HOLBROOK EMS INC.
  • Classification: Ambulance - 3416L0300X
  • Specialization: Land Transport
  • Entity Type: Organization
  • CLIA Number: 03D1029374
  • Address: 30 W VISTA DR
    HOLBROOK, AZ
    ZIP 86025
  • Phone: (928) 524-2190

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NPI Details

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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ground mileage, per statute mile (HCPCS:A0425)
  • Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) (HCPCS:A0427)
  • Ambulance service, basic life support, emergency transport (bls-emergency) (HCPCS:A0429)

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
13416L0300XAmbulanceLand TransportYes

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
1Z=========MEDICARE ID-TYPE UNSPECIFIEDARIZONA
2590005381MEDICARE ID-TYPE UNSPECIFIEDRAILROAD
3AZ0151060OTHERARIZONABLUE CROSS BLUE SHIELD
4071837MEDICARE ID-TYPE UNSPECIFIEDARIZONA

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: 11/21/2025

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