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General NPI Number Information
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NPI Number | 1528325255
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Entity Type | Organization
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Legal Business Name | EMS TEAM LLC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 2740 W NATIONAL RD
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City | DAYTON
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State | OH
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Zip | 45414-1108
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Country | US
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Telephone | 800-735-8190
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Fax |
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Provider Business Mailing Address
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Address Line | 1371 W RAHN RD
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City | DAYTON
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State | OH
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Zip | 45459-1431
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Country | US
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Telephone | 937-949-4611
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DERECK M PRISTAS
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Credential |
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Telephone | 800-735-8190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 570122
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License Number State | OH
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