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General NPI Number Information
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NPI Number | 1396826749
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Entity Type | Organization
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Legal Business Name | BRICKNER AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 419 S WASHINGTON ST
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City | VAN WERT
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State | OH
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Zip | 45891-1944
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Country | US
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Telephone | 419-238-2381
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Fax | 419-238-2382
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Provider Business Mailing Address
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Address Line | 419 S WASHINGTON ST
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City | VAN WERT
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State | OH
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Zip | 45891-1944
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Country | US
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Telephone | 419-238-2381
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Fax | 419-238-2382
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES C. BRICKNER
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Credential |
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Telephone | 419-238-2381
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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 | 810017
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License Number State | OH
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