Organization
MANTECA DISTRICT VOLUNTEER AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA LOU ANN ANAYA (BILLING MANAGER)
(209) 823-1032
Entity
Organization
Contact information
Practice address
245 E CENTER ST, MANTECA, CA 95336-4623
(209) 823-1032
(209) 825-9607
Mailing address
PO BOX 2, MANTECA, CA 95336-1120
(209) 823-1032
(209) 825-9607
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ32662Z
—
CA
Enumeration date
10/20/2006
Last updated
01/05/2012
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