Provider Demographics
NPI:1790010023
Name:MERCY AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:MERCY AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:E
Authorized Official - Last Name:ESTERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-956-3342
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-0743
Mailing Address - Country:US
Mailing Address - Phone:855-956-3342
Mailing Address - Fax:
Practice Address - Street 1:7700 IMPERIAL HWY
Practice Address - Street 2:SUITE D
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3469
Practice Address - Country:US
Practice Address - Phone:626-536-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport