Healthcare Provider Details

I. General information

NPI: 1346292364
Provider Name (Legal Business Name): 4M EMERGENCY SYSTEMS ANDOVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 S MAIN ST
ANDOVER OH
44003-9602
US

IV. Provider business mailing address

12420 MILESTONE CENTER DR STE 200
GERMANTOWN MD
20876-7111
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-4000
  • Fax: 330-656-5901
Mailing address:
  • Phone: 240-686-2300
  • Fax: 240-686-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY CHARLEY
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 240-686-2300