Provider Demographics
NPI:1437157252
Name:AMERICAN MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:AMERICAN MEDICAL TRANSPORT INC.
Other - Org Name:CENTRAL COAST AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHELSTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-685-3201
Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95012
Mailing Address - Country:US
Mailing Address - Phone:831-685-3201
Mailing Address - Fax:831-633-5263
Practice Address - Street 1:600 E BEL MAR DR
Practice Address - Street 2:
Practice Address - City:LA SELVA BEACH
Practice Address - State:CA
Practice Address - Zip Code:95076-6400
Practice Address - Country:US
Practice Address - Phone:831-685-3201
Practice Address - Fax:831-633-5263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA16119IOtherPACIFICARE
CA590014697OtherRAILROAD MEDICARE
CAMTE01001FMedicaid
CAZZZ06390ZOtherBLUE SHIELD
CA590014697OtherRAILROAD MEDICARE