Provider Demographics
NPI:1952475493
Name:NAPA COUNTY COMMUNITY AMBULANCE
Entity Type:Organization
Organization Name:NAPA COUNTY COMMUNITY AMBULANCE
Other - Org Name:ANGWIN COMMUNITY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-965-2468
Mailing Address - Street 1:PO BOX 947
Mailing Address - Street 2:
Mailing Address - City:ANGWIN
Mailing Address - State:CA
Mailing Address - Zip Code:94508-6047
Mailing Address - Country:US
Mailing Address - Phone:707-965-9110
Mailing Address - Fax:707-965-9117
Practice Address - Street 1:275 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ANGWIN
Practice Address - State:CA
Practice Address - Zip Code:94508
Practice Address - Country:US
Practice Address - Phone:707-965-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78288ZMedicaid
CAZZZ78288ZMedicaid