Provider Demographics
NPI:1558331405
Name:AMERICAN AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:AMERICAN AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:C
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-342-0404
Mailing Address - Street 1:5935 HENNINGER DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1269
Mailing Address - Country:US
Mailing Address - Phone:402-342-0404
Mailing Address - Fax:
Practice Address - Street 1:5935 HENNINGER DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1269
Practice Address - Country:US
Practice Address - Phone:402-342-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid