Provider Demographics
NPI:1932153335
Name:CENTURY AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:CENTURY AMBULANCE SERVICE, INC.
Other - Org Name:CENTURY EMS - COLUMBIA COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-217-2652
Mailing Address - Street 1:740 GREELAND AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-4404
Mailing Address - Country:US
Mailing Address - Phone:904-356-0835
Mailing Address - Fax:904-356-9677
Practice Address - Street 1:740 GREELAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-4404
Practice Address - Country:US
Practice Address - Phone:904-356-0835
Practice Address - Fax:904-356-9677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
FL0025663416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015450000Medicaid
FLA0516Medicare ID - Type Unspecified