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General NPI Number Information
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NPI Number | 1487947065
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Entity Type | Organization
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Legal Business Name | FIRSTMED, INC
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 1941 SELMARTEN RD
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City | AURORA
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State | IL
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Zip | 60505-1337
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Country | US
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Telephone | 630-851-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 1941 SELMARTEN RD
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City | AURORA
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State | IL
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Zip | 60505-1337
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JERALD C GORDON
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Credential |
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Telephone | 630-851-2255
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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 | 08 858501
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License Number State | IL
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