Provider Demographics
NPI:1902886971
Name:THOMPSON VALLEY EMERGENCY MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:THOMPSON VALLEY EMERGENCY MEDICAL SERVICES INC
Other - Org Name:THOMPSON VALLEY EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARVI
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOLGENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-663-6025
Mailing Address - Street 1:4480 CLYDESDALE PKWY
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9081
Mailing Address - Country:US
Mailing Address - Phone:970-663-6025
Mailing Address - Fax:970-667-0172
Practice Address - Street 1:4480 CLYDESDALE PKWY
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9081
Practice Address - Country:US
Practice Address - Phone:970-663-6025
Practice Address - Fax:970-667-0172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590015097OtherMEDICARE RAILROAD
CO20602898Medicaid
590015097OtherMEDICARE RAILROAD