Provider Demographics
NPI:1871266882
Name:PREFERRED ONE AMBULANCE
Entity Type:Organization
Organization Name:PREFERRED ONE AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-262-0015
Mailing Address - Street 1:651 E US HIGHWAY 20 STE 1
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7419
Mailing Address - Country:US
Mailing Address - Phone:219-262-0015
Mailing Address - Fax:
Practice Address - Street 1:651 E US HIGHWAY 20 STE 1
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-7419
Practice Address - Country:US
Practice Address - Phone:219-262-0015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance