Provider Demographics
NPI:1790761864
Name:UNITED AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:UNITED AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:T
Authorized Official - Last Name:DURNEY-MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-981-0400
Mailing Address - Street 1:2701 SHENANDOAH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-5249
Mailing Address - Country:US
Mailing Address - Phone:540-981-0400
Mailing Address - Fax:540-344-6712
Practice Address - Street 1:2701 SHENANDOAH AVE NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-5249
Practice Address - Country:US
Practice Address - Phone:540-981-0400
Practice Address - Fax:540-344-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA096165OtherANTHEM BCBS
VA1299888OtherUMWA