Provider Demographics
NPI:1396742912
Name:ACTION MEDICAL SERVICE INC.
Entity type:Organization
Organization Name:ACTION MEDICAL SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-289-9229
Mailing Address - Street 1:1200 E SECOND ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:AZ
Mailing Address - Zip Code:86047-4130
Mailing Address - Country:US
Mailing Address - Phone:928-289-9229
Mailing Address - Fax:928-829-6445
Practice Address - Street 1:1200 E SECOND ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:AZ
Practice Address - Zip Code:86047-4130
Practice Address - Country:US
Practice Address - Phone:928-289-9229
Practice Address - Fax:928-829-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR3158Medicaid
AZ054578Medicaid
AZAZ0151910OtherBC/BS
NMR3158Medicaid
AZ590012907Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NMR3158Medicaid