Organization
MT. SHASTA AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVANGELOS JAMES BANOS PARAMEDIC (OWNER)
(530) 926-2665
Entity
Organization
Contact information
Practice address
1020 OAK ST, MOUNT SHASTA, CA 96067-9492
(530) 926-2665
Mailing address
1020 OAK ST, PO BOX 1030, MOUNT SHASTA, CA 96067-9492
(530) 926-2665
(530) 926-5001
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
43733
CA
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ79378Z
—
CA
Enumeration date
03/21/2007
Last updated
08/22/2024
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