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 | 085759 | OTHER | | BCBS CHATANOOGA TN |
| 2 | 0084274 | OTHER | | AETNA BLUE BELL |
| 3 | 085759 | OTHER | | BCBS ALBANY NY |
| 4 | 085759 | OTHER | | BCBS CLEVELAND OH |
| 5 | 085759 | OTHER | | BCBS DATA CAPTURE |
| 6 | 085759 | OTHER | | BCBS INDEPENDT PA |
| 7 | 085759 | OTHER | | BCBS DURHAM NC |
| 8 | 800793 | OTHER | | TUFTS HEALTH PLAN |
| 9 | 085759 | OTHER | | BCBS BIRMINGHAM AL |
| 10 | 085759 | OTHER | | BCBS COLUMBUS GA |
| 11 | 085759 | OTHER | | BCBS CHICAGO IL |
| 12 | 085759 | OTHER | | BCBS DETROIT MI POB 2500 |
| 13 | 085759 | OTHER | | BCBS BUFFALO NY |
| 14 | 085759 | OTHER | | BCBS CAMP HILL PA |
| 15 | 085759 | OTHER | | BCBS DALLAS TX |
| 16 | 085759 | OTHER | | ANTHEM BCBS NORTH HAVEN |
| 17 | 085759 | MEDICARE ID-TYPE UNSPECIFIED | | |
| 18 | 1713108 | MEDICAID | MASSACHUSETTS | |
| 19 | 085759 | OTHER | | BCBS DETROIT MI POB 166 |
| 20 | 700343 | OTHER | | HARVARD PILGRIM HEALTHCAR |
