Provider Demographics
NPI:1134879877
Name:FRONTLINE AMBULANCE LLC
Entity type:Organization
Organization Name:FRONTLINE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TALMADGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-947-9606
Mailing Address - Street 1:5 BRAYTON CT
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1359
Mailing Address - Country:US
Mailing Address - Phone:619-947-9606
Mailing Address - Fax:
Practice Address - Street 1:12862 GARDEN GROVE BLVD STE H
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2021
Practice Address - Country:US
Practice Address - Phone:619-947-9606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance