Provider Demographics
NPI:1689608994
Name:SPRINGS AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:SPRINGS AMBULANCE SERVICE, INC.
Other - Org Name:AMERICAN MEDICAL RESPONSE (AMR)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 55418
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5418
Mailing Address - Country:US
Mailing Address - Phone:800-913-9106
Mailing Address - Fax:
Practice Address - Street 1:1111 MONTALVO WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5440
Practice Address - Country:US
Practice Address - Phone:760-883-5000
Practice Address - Fax:760-883-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ90310ZOtherBLUESHIELD OF CALIFORNIA
CAZZZ34427ZOtherMOLINA HEALTH PLAN
CA011734OtherSCAN HEALTH PLAN
CAZZZ34427ZMedicaid
CA197829200OtherWORKERS COMP DEPT OF LAB
CA197829200OtherWORKERS COMP DEPT OF LAB
CA590134054Medicare PIN
CAZZZ34427ZOtherMOLINA HEALTH PLAN