Provider Demographics
NPI:1124020607
Name:MONROVIA ARCADIA AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:MONROVIA ARCADIA AMBULANCE SERVICE INC
Other - Org Name:MONARC AMBULANCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:COCHREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-256-9386
Mailing Address - Street 1:230 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2250
Mailing Address - Country:US
Mailing Address - Phone:626-256-9386
Mailing Address - Fax:626-359-9271
Practice Address - Street 1:230 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2250
Practice Address - Country:US
Practice Address - Phone:626-256-9386
Practice Address - Fax:626-359-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-13
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABUS2005-00182341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000030139OtherMEDICARE SUBMITTER NUMBER
CA000030139OtherMEDICARE SUBMITTER NUMBER