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General NPI Number Information
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NPI Number | 1275531170
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Entity Type | Organization
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Legal Business Name | L.J.LEWIS ENTERPRISES, INC
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 421 SOUTH ST SE
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City | WARREN
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State | OH
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Zip | 44483-5719
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Country | US
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Telephone | 330-369-3600
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Fax | 330-395-0110
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Provider Business Mailing Address
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Address Line | 421 SOUTH ST SE
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City | WARREN
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State | OH
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Zip | 44483-5719
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Country | US
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Telephone | 330-369-3600
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Fax | 330-395-0110
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN L POPADAK
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Credential |
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Telephone | 330-369-3600
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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 | 780012
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 780012
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 780012
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License Number State | OH
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