Provider Demographics
NPI:1841381514
Name:NEWCASTLE AMBULANCE SERVICE
Entity Type:Organization
Organization Name:NEWCASTLE AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:K
Authorized Official - Last Name:HESPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-746-2800
Mailing Address - Street 1:P O BOX 492
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WY
Mailing Address - Zip Code:82701
Mailing Address - Country:US
Mailing Address - Phone:307-746-2800
Mailing Address - Fax:
Practice Address - Street 1:7 W WENWORTH
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WY
Practice Address - Zip Code:82701
Practice Address - Country:US
Practice Address - Phone:307-746-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY116259400Medicaid
SD9011090OtherSOUTH DAKATO MEDICAID
WY310997OtherBLUE CROSS BLUE SHIELD
SD9011090OtherSOUTH DAKATO MEDICAID
WY116259400Medicaid