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General NPI Number Information
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NPI Number | 1184273450
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Entity Type | Organization
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Legal Business Name | PHOENIX PARAMEDIC SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 1600 KEPNER DR STE E
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City | LAFAYETTE
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State | IN
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Zip | 47905-7436
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Country | US
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Telephone | 765-448-4327
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Fax | 765-448-4694
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Provider Business Mailing Address
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Address Line | 1600 KEPNER DR STE E
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City | LAFAYETTE
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State | IN
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Zip | 47905-7436
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Country | US
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Telephone | 765-448-4327
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | NATHANIEL A METZ
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Credential |
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Telephone | 765-448-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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