Basic Information
Provider Information | |||||||||
NPI: | 1144270067 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | RAMROD | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | ARKANSAS VALLEY AMBULANCE | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2233 E MAIN ST | ||||||||
Address2: | BUSINESS OPTIONS MEDICAL BILLING | ||||||||
City: | MONTROSE | ||||||||
State: | CO | ||||||||
PostalCode: | 814013831 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9707650818 | ||||||||
FaxNumber: | 9704978410 | ||||||||
Practice Location | |||||||||
Address1: | 8274 US HIGHWAY 50 | ||||||||
Address2: |   | ||||||||
City: | HOWARD | ||||||||
State: | CO | ||||||||
PostalCode: | 81233 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7192762125 | ||||||||
FaxNumber: | 9704978410 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/11/2006 | ||||||||
LastUpdateDate: | 04/19/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | MCFARLAND | ||||||||
AuthorizedOfficialFirstName: | RONALD | ||||||||
AuthorizedOfficialMiddleName: | E | ||||||||
AuthorizedOfficialTitleorPosition: | VICE PRESIDENT, ACTING PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 7199424643 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X |   |   | Y |   | Transportation Services | Ambulance | Land Transport |
ID Information
ID | Type | State | Issuer | Description | 06000210 | 05 | CO |   | MEDICAID | 590014506 | 01 |   | RAILROAD WORKERS MEDICARE | OTHER | 617823700 | 01 |   | DEPT OF LABOR FEDERAL WORKERS COMPENSATION | OTHER |