Provider Demographics
NPI:1659604734
Name:TRI-MEDIC INC
Entity Type:Organization
Organization Name:TRI-MEDIC INC
Other - Org Name:ALLEN AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-732-9156
Mailing Address - Street 1:9602 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-2027
Mailing Address - Country:US
Mailing Address - Phone:323-732-9156
Mailing Address - Fax:323-293-4514
Practice Address - Street 1:9602 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-2027
Practice Address - Country:US
Practice Address - Phone:323-732-9156
Practice Address - Fax:323-292-4514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA409296341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance