Provider Demographics
NPI:1912141052
Name:MEDFIRST INC AMBULETTE SERVICES
Entity Type:Organization
Organization Name:MEDFIRST INC AMBULETTE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:VILLANUEVA
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:RNC-MHA
Authorized Official - Phone:718-676-9178
Mailing Address - Street 1:1532 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3930
Mailing Address - Country:US
Mailing Address - Phone:718-676-9178
Mailing Address - Fax:718-513-6391
Practice Address - Street 1:1532 E 54TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3930
Practice Address - Country:US
Practice Address - Phone:718-676-9178
Practice Address - Fax:718-513-6391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDFIRST IN STAFFING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)