There have been several advertisements for Telephony Denial of Service (TDoS) attack services popping up. I provided a link to one below. These seem to come and go, as they are removed from sites, but this one has been up for a while. The service is very cheap, $70 for week, which if targeted towards a hospital emergency room, Intensive Care Unit (ICU), public safety site, or any small business, where there are a handful of critical phones and attendants, this service would be very disruptive. Of course there are other ways to do this yourself - using Asterisk and SIP trunking, but this is easier for a non-technical attacker.
They even offer a 10 minute free trial :)
Since I saw the service, it has been enhanced to state that the calls can be made with different source numbers. I don't know how sophisticated this is - are they random, legit numbers, etc., but of course this makes an attack much harder to deal with.
It isn't clear what the flood capacity is. it says the interval between calls is 1-3 seconds. The calls are automatically generated. You have the option of playing an audio file, but that costs more (requires the attacker to generate RTP).
http://hacksociety.net/Thread-TDoS-Telephony-denial-of-service-attack
If anyone tries it out, please let me know the results.