Provider Demographics
NPI: | 1386905016 |
---|---|
Name: | FALCK NORTHERN CALIFORNIA CORP. |
Entity type: | Organization |
Organization Name: | FALCK NORTHERN CALIFORNIA CORP. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF LEGAL COUNSEL |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BRIAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RICHMOND |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 425-478-8318 |
Mailing Address - Street 1: | 28333 INDUSTRIAL BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | HAYWARD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94545-4428 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 844-622-3926 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 28333 INDUSTRIAL BLVD |
Practice Address - Street 2: | |
Practice Address - City: | HAYWARD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94545-4428 |
Practice Address - Country: | US |
Practice Address - Phone: | 844-622-3926 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | FALCK USA, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2012-05-29 |
Last Update Date: | 2020-06-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 341600000X | Transportation Services | Ambulance |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 1386905016 | Medicaid |