Provider Demographics
NPI:1770820375
Name:TRINITY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TRINITY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-582-8481
Mailing Address - Street 1:5741 S STATE ROAD 61
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:IN
Mailing Address - Zip Code:47598-8929
Mailing Address - Country:US
Mailing Address - Phone:812-582-8481
Mailing Address - Fax:800-381-9767
Practice Address - Street 1:5741 S STATE ROAD 61
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:IN
Practice Address - Zip Code:47598-8929
Practice Address - Country:US
Practice Address - Phone:812-582-8481
Practice Address - Fax:800-381-9767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport