Provider Demographics
NPI:1265469142
Name:RIGGS AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:RIGGS AMBULANCE SERVICE INC
Other - Org Name:MERCED MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:BONIFAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-725-7000
Mailing Address - Street 1:1827 CANAL STREET
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-4812
Mailing Address - Country:US
Mailing Address - Phone:209-722-3832
Mailing Address - Fax:209-722-2779
Practice Address - Street 1:1827 CANAL STREET
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4812
Practice Address - Country:US
Practice Address - Phone:209-722-3832
Practice Address - Fax:209-722-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100030332B00000X
CA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ35992ZMedicaid
CAZZZ35992ZMedicaid