Provider Demographics
NPI:1386114643
Name:EAGLE AMBULANCE
Entity type:Organization
Organization Name:EAGLE AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BULDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-291-2342
Mailing Address - Street 1:333 HEGENBERGER RD STE 855
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1416
Mailing Address - Country:US
Mailing Address - Phone:510-452-1100
Mailing Address - Fax:510-452-1110
Practice Address - Street 1:333 HEGENBERGER RD STE 855
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1416
Practice Address - Country:US
Practice Address - Phone:510-452-1100
Practice Address - Fax:510-452-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance