Provider Demographics
NPI:1568711299
Name:RG AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:RG AMBULANCE SERVICE, INC.
Other - Org Name:ALL COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-876-2100
Mailing Address - Street 1:2766 NW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-7662
Mailing Address - Country:US
Mailing Address - Phone:772-465-1111
Mailing Address - Fax:772-466-1150
Practice Address - Street 1:4227 SAINT LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34946-9000
Practice Address - Country:US
Practice Address - Phone:888-876-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)