Healthcare Provider Details

I. General information

NPI: 1487910360
Provider Name (Legal Business Name): MERCY HEALTH MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 CORPORATE DR
BLUE ASH OH
45242-2101
US

IV. Provider business mailing address

6510 CORPORATE DR
BLUE ASH OH
45242-2101
US

V. Phone/Fax

Practice location:
  • Phone: 513-330-5469
  • Fax:
Mailing address:
  • Phone: 513-330-5469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. GREGORY R BEAUCHEMIN
Title or Position: CEO
Credential:
Phone: 248-304-6023