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General NPI Number Information
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NPI Number | 1235292129
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICAL FOUNDATION INC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 112 CARSWELL AVE
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City | HOLLY HILL
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State | FL
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Zip | 32117-5010
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Country | US
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Telephone | 386-252-4900
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Fax | 386-252-4986
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Provider Business Mailing Address
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Address Line | 112 CARSWELL AVE
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City | HOLLY HILL
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State | FL
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Zip | 32117-5010
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Country | US
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Telephone | 386-252-4900
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Fax | 386-252-4986
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MICHAEL J MELLON
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Credential |
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Telephone | 386-252-4900
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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 | 2959
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License Number State | FL
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