Provider Demographics
NPI:1639271885
Name:COUNTY OF MANATEE
Entity Type:Organization
Organization Name:COUNTY OF MANATEE
Other - Org Name:MANATEE COUNTY EMERGENCY MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRUTCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-744-3981
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34206-0589
Mailing Address - Country:US
Mailing Address - Phone:941-744-3981
Mailing Address - Fax:941-749-3579
Practice Address - Street 1:2101 47TH TER E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3785
Practice Address - Country:US
Practice Address - Phone:941-744-3981
Practice Address - Fax:941-749-3579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLALS4102341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0880302-00Medicaid
FLA0301Medicare PIN