Healthcare Provider Details

I. General information

NPI: 1104825991
Provider Name (Legal Business Name): MEDIC 9 PARAMEDIC SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 BLUE VALLEY DR
BANGOR PA
18013-1528
US

IV. Provider business mailing address

311 BLUE VALLEY DR
BANGOR PA
18013-1528
US

V. Phone/Fax

Practice location:
  • Phone: 610-588-9816
  • Fax: 610-588-9818
Mailing address:
  • Phone: 610-588-9816
  • Fax: 610-588-9818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number02275
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD ALAN DEREAMUS
Title or Position: EMS COORDINATOR
Credential:
Phone: 610-588-9816