=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417040007
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBINAUGH EMS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2006
-----------------------------------------------------
Last Update Date | 07/21/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 HUNTER PLACE
-----------------------------------------------------
City | BELLEFONTAINE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43311-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-599-2340
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 HUNTER PLACE
-----------------------------------------------------
City | BELLEFONTAINE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43311-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-599-2340
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DARIN ROBINAUGH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-599-2340
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 460042
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------