Provider Demographics
NPI:1841388857
Name:HUGHSON PARAMEDIC AMBULANCE COMPANY, INC
Entity Type:Organization
Organization Name:HUGHSON PARAMEDIC AMBULANCE COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-883-9177
Mailing Address - Street 1:PO BOX 1719
Mailing Address - Street 2:
Mailing Address - City:HUGHSON
Mailing Address - State:CA
Mailing Address - Zip Code:95326-1719
Mailing Address - Country:US
Mailing Address - Phone:209-883-9177
Mailing Address - Fax:209-883-4178
Practice Address - Street 1:2419 CHARLES STREET
Practice Address - Street 2:
Practice Address - City:HUGHSON
Practice Address - State:CA
Practice Address - Zip Code:95326-1719
Practice Address - Country:US
Practice Address - Phone:209-883-9177
Practice Address - Fax:209-883-4178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1034183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA590005707OtherRAIL ROAD MEDICARE
CA183594700OtherDEPARTMENT OF LABOR
CAMTE00460FMedicaid
CAZZZ25308ZOtherBLUE SHIELD
CA183594700OtherDEPARTMENT OF LABOR