Provider Demographics
NPI:1467686709
Name:AMBULETTE MEDICAR SERVICE
Entity Type:Organization
Organization Name:AMBULETTE MEDICAR SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MACZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-767-9642
Mailing Address - Street 1:1460 FAIRLANE DR APT 321
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-3567
Mailing Address - Country:US
Mailing Address - Phone:630-767-9642
Mailing Address - Fax:847-574-7447
Practice Address - Street 1:1460 FAIRLANE DR APT 321
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-3567
Practice Address - Country:US
Practice Address - Phone:630-767-9642
Practice Address - Fax:847-574-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)