Provider Demographics
NPI:1316037286
Name:RESPONSE AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:RESPONSE AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUREIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-998-4305
Mailing Address - Street 1:PO BOX 79597
Mailing Address - Street 2:654 STATE ROAD
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747
Mailing Address - Country:US
Mailing Address - Phone:508-993-4305
Mailing Address - Fax:508-990-1564
Practice Address - Street 1:654 STATE ROAD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747
Practice Address - Country:US
Practice Address - Phone:508-993-4305
Practice Address - Fax:508-990-1564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3963341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1713124Medicaid
MA084059Medicare ID - Type Unspecified
MA590005650Medicare UPIN