Healthcare Provider Details
I. General information
NPI: 1891804167
Provider Name (Legal Business Name): MILROY EMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
214 W MAIN ST
MILROY IN
46156-9405
US
IV. Provider business mailing address
PO BOX 2915
ELKHART IN
46515-2915
US
V. Phone/Fax
- Phone: 765-629-2172
- Fax: 765-629-2000
- Phone: 574-293-3030
- Fax: 574-294-1345
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 0266 |
| License Number State | IN |
VIII. Authorized Official
Name:
DARCY
CONLEY
Title or Position: BOARD PRESIDENT
Credential:
Phone: 765-629-2172