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General NPI Number Information
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NPI Number | 1184779225
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL TRANSPORTATION, INC.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 1230 ALDERWOOD AVE
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City | SUNNYVALE
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State | CA
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Zip | 94089-2201
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Country | US
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Telephone | 510-614-1423
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Fax | 510-614-1420
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Provider Business Mailing Address
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Address Line | PO BOX 5004
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City | MARIPOSA
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State | CA
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Zip | 95338-5004
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Country | US
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Telephone | 209-742-5286
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Fax | 209-966-4901
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD FRED ROESCH
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Credential | CEO
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Telephone | 800-456-7142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | A195
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License Number State | CA
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