Provider Demographics
NPI:1073822987
Name:MEDONE AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:MEDONE AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-890-0982
Mailing Address - Street 1:13173 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-2560
Mailing Address - Country:US
Mailing Address - Phone:818-890-0982
Mailing Address - Fax:818-896-3782
Practice Address - Street 1:13173 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-2560
Practice Address - Country:US
Practice Address - Phone:818-890-0982
Practice Address - Fax:818-896-3782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000000Medicare UPIN
0000000000Medicare NSC
0000000000Medicare Oscar/Certification
0000000000Medicare PIN