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General NPI Number Information
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NPI Number | 1497058846
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Entity Type | Organization
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Legal Business Name | PATRIOT EMERGENCY MEDICAL SERVICE
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 2914 S 4TH ST
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City | IRONTON
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State | OH
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Zip | 45638-2867
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Country | US
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Telephone | 740-532-2222
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Fax | 740-532-4344
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Provider Business Mailing Address
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Address Line | PO BOX 4434
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City | IRONTON
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State | OH
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Zip | 45638-4434
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Country | US
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Telephone | 740-532-2222
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Fax | 740-532-4344
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | DAVID H ROTTER
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Credential | NREMT-P
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Telephone | 740-532-2222
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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 | 440022
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License Number State | OH
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