Healthcare Provider Details

I. General information

NPI: 1356816680
Provider Name (Legal Business Name): SOUTH WESTERN AMBULANCE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2018
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 BUSCH BLVD STE 84
COLUMBUS OH
43229-2548
US

IV. Provider business mailing address

6161 BUSCH BLVD SUIT 84
COLUMBUS OH
43224
US

V. Phone/Fax

Practice location:
  • Phone: 614-348-2852
  • Fax: 866-390-4835
Mailing address:
  • Phone: 614-348-2852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. ANWAR K ADAM
Title or Position: OWNER
Credential:
Phone: 614-348-2852