Healthcare Provider Details

I. General information

NPI: 1477418564
Provider Name (Legal Business Name): MEDI SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FREDERICK CT # 304
CARLISLE PA
17013-7704
US

IV. Provider business mailing address

1 FREDERICK CT # 304
CARLISLE PA
17013-7704
US

V. Phone/Fax

Practice location:
  • Phone: 717-422-4954
  • Fax:
Mailing address:
  • Phone: 717-422-4954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: KEIVAN ROSTAMI
Title or Position: EMPLOYEE
Credential:
Phone: 717-422-4954