# DARRELL EUGENE FROST DBA NORTHERN SISKIYOU AMBULANCE SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790839702
- **Authorized official:** MR. DARRELL FROST MICP (OWNER)
- **Authorized official phone:** (530) 842-3583

## Contact information

- **Practice address:** 553 N MAIN ST, YREKA, CA 96097-2524
- **Practice address phone:** (530) 842-3583
- **Practice address fax:** (530) 842-6672
- **Mailing address:** PO BOX 850, YREKA, CA 96097-0850
- **Mailing address phone:** (530) 842-3583
- **Mailing address fax:** (530) 842-6672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 101765 | CA | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | 101765 | CA | — |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 06/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | MTE00243F | — | CA |
| 05 | — | MTN00777F | — | CA |