Provider Demographics
NPI:1083613921
Name:COUNTY OF TUOLUMNE
Entity Type:Organization
Organization Name:COUNTY OF TUOLUMNE
Other - Org Name:TUOLUMNE COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-533-7368
Mailing Address - Street 1:PO BOX 5024
Mailing Address - Street 2:18440 STRIKER COURT
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5024
Mailing Address - Country:US
Mailing Address - Phone:209-533-7368
Mailing Address - Fax:209-533-5726
Practice Address - Street 1:18440 STRIKER CT
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-7555
Practice Address - Country:US
Practice Address - Phone:209-533-7368
Practice Address - Fax:209-533-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA590004033OtherRAILROAD MEDICARE
CAMTE00259FMedicaid
CACGP133315OtherCALIF. CHILDRENS SERVICES
CAMTE00259FMedicaid