Provider Demographics
NPI:1760745343
Name:FRONTIER AMBULANCE SERVICE TRANSPORTS
Entity Type:Organization
Organization Name:FRONTIER AMBULANCE SERVICE TRANSPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-910-3635
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:TONOPAH
Mailing Address - State:NV
Mailing Address - Zip Code:89049-0667
Mailing Address - Country:US
Mailing Address - Phone:775-910-3635
Mailing Address - Fax:
Practice Address - Street 1:410 CRYSTAL AVE.
Practice Address - Street 2:
Practice Address - City:GOLDFIELD
Practice Address - State:NV
Practice Address - Zip Code:89013
Practice Address - Country:US
Practice Address - Phone:775-910-3635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport