Provider Demographics
NPI:1659392975
Name:PRIORITY 1 AMBULANCE SERVICES, LLC
Entity Type:Organization
Organization Name:PRIORITY 1 AMBULANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER-GROUND AMBULAN
Authorized Official - Phone:804-639-9112
Mailing Address - Street 1:PO BOX 4098
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-7334
Mailing Address - Country:US
Mailing Address - Phone:804-639-9112
Mailing Address - Fax:804-674-5968
Practice Address - Street 1:3819 HENDRICKS RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-7334
Practice Address - Country:US
Practice Address - Phone:804-639-9112
Practice Address - Fax:804-674-5968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA12263416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00242642OtherMEDICARE RAILROAD
VA178932OtherANTHEM BCBS
VA010163641Medicaid
VA178932OtherANTHEM BCBS