Provider Demographics
NPI:1356659817
Name:PRO MEDIC AMBULANCE INC
Entity Type:Organization
Organization Name:PRO MEDIC AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARAFIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-761-0028
Mailing Address - Street 1:11480 OXNARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4128
Mailing Address - Country:US
Mailing Address - Phone:818-761-0028
Mailing Address - Fax:818-761-0049
Practice Address - Street 1:11480 OXNARD ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4128
Practice Address - Country:US
Practice Address - Phone:818-761-0028
Practice Address - Fax:818-761-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport