Provider Demographics
NPI:1477507663
Name:ASHAWAY AMBULANCE ASSOCIATION INC
Entity Type:Organization
Organization Name:ASHAWAY AMBULANCE ASSOCIATION INC
Other - Org Name:ASHAWAY AMBULANCE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:TEEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-572-3120
Mailing Address - Street 1:PO BOX 8879
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0879
Mailing Address - Country:US
Mailing Address - Phone:401-572-3120
Mailing Address - Fax:401-572-3351
Practice Address - Street 1:72 HIGH ST
Practice Address - Street 2:
Practice Address - City:ASHAWAY
Practice Address - State:RI
Practice Address - Zip Code:02804
Practice Address - Country:US
Practice Address - Phone:401-377-8312
Practice Address - Fax:401-377-8392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIEMS00006341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9009948Medicaid
RIP01042336OtherRAILROAD MEDICARE
RI9009948Medicaid