Healthcare Provider Details

I. General information

NPI: 1407246952
Provider Name (Legal Business Name): HEARTS EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9004 S MERRILL AVE
CHICAGO IL
60617-3811
US

IV. Provider business mailing address

9004 S MERRILL AVE
CHICAGO IL
60617-3811
US

V. Phone/Fax

Practice location:
  • Phone: 773-412-0460
  • Fax:
Mailing address:
  • Phone: 773-412-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberP62054473659
License Number StateIL

VIII. Authorized Official

Name: MELINDA D PRICE
Title or Position: OWNER
Credential:
Phone: 773-412-0460