Provider Demographics
NPI:1245230192
Name:EAST CARBON CITY
Entity Type:Organization
Organization Name:EAST CARBON CITY
Other - Org Name:EAST CARBON CITY-SUNNYSIDE AMBULANCE SVC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-650-0299
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:101 WEST GENEVA DRIVE
Mailing Address - City:EAST CARBON
Mailing Address - State:UT
Mailing Address - Zip Code:84520-0070
Mailing Address - Country:US
Mailing Address - Phone:435-650-0299
Mailing Address - Fax:435-888-0409
Practice Address - Street 1:101 WEST GENEVA DRIVE
Practice Address - Street 2:
Practice Address - City:EAST CARBON
Practice Address - State:UT
Practice Address - Zip Code:84520-0070
Practice Address - Country:US
Practice Address - Phone:435-650-0299
Practice Address - Fax:435-888-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0401L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
0562432OtherUMWA
590000882OtherRAILROAD MEDICARE
UT729108Medicaid
UT729108Medicaid