Provider Demographics
NPI:1740699172
Name:CARE FIRST AMBULETTE SERVICE LLC
Entity type:Organization
Organization Name:CARE FIRST AMBULETTE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROETTGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-936-1724
Mailing Address - Street 1:2342 PIRATES BAY DR
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-7950
Mailing Address - Country:US
Mailing Address - Phone:800-936-1724
Mailing Address - Fax:
Practice Address - Street 1:2342 PIRATES BAY DR
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-7950
Practice Address - Country:US
Practice Address - Phone:800-936-1724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)