Provider Demographics
NPI:1649835414
Name:SANTA ROSA AMBULANCE LLC
Entity type:Organization
Organization Name:SANTA ROSA AMBULANCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-306-0000
Mailing Address - Street 1:7007 WIMBLEDON ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7322
Mailing Address - Country:US
Mailing Address - Phone:281-306-0000
Mailing Address - Fax:281-306-0000
Practice Address - Street 1:7007 WIMBLEDON ESTATES DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7322
Practice Address - Country:US
Practice Address - Phone:281-306-0000
Practice Address - Fax:281-306-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport