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General NPI Number Information
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NPI Number | 1154825750
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Entity Type | Organization
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Legal Business Name | PARRISH MEDI-VAN
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 275 SW YOUNG PL
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City | LAKE CITY
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State | FL
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Zip | 32025-2181
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Country | US
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Telephone | 386-758-3003
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Fax | 386-758-3064
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Provider Business Mailing Address
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Address Line | 1101 SW TUSTENUGGEE AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-2164
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Country | US
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Telephone | 386-758-3003
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Fax | 386-758-3064
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Authorized Official
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Title or Position | OWNER
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Name | BRENDA LITTRELL
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Credential |
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Telephone | 386-758-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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