Provider Demographics
NPI:1356067037
Name:BROUGHAM AMBULANCE
Entity type:Organization
Organization Name:BROUGHAM AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SARKIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEKSANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-935-4142
Mailing Address - Street 1:17430 CHATSWORTH ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5717
Mailing Address - Country:US
Mailing Address - Phone:747-999-7545
Mailing Address - Fax:
Practice Address - Street 1:17430 CHATSWORTH ST UNIT 3
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5717
Practice Address - Country:US
Practice Address - Phone:747-999-7545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport