Provider Demographics
NPI:1477669489
Name:TOP AMBULANCE SERVICE INCORPORATED
Entity Type:Organization
Organization Name:TOP AMBULANCE SERVICE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOMM
Authorized Official - Suffix:SR
Authorized Official - Credentials:BILLER
Authorized Official - Phone:978-618-1730
Mailing Address - Street 1:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3264
Mailing Address - Country:US
Mailing Address - Phone:978-562-4518
Mailing Address - Fax:978-562-4558
Practice Address - Street 1:308 CENTRAL ST
Practice Address - Street 2:UNIT 4
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-1304
Practice Address - Country:US
Practice Address - Phone:978-562-4518
Practice Address - Fax:978-562-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1700308Medicaid
MA1700308Medicaid