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General NPI Number Information
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NPI Number | 1598849010
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Entity Type | Organization
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Legal Business Name | PELLIN EMERGENCY MED SE
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 10808 AKRON-CANFIELD RD
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City | ELLSWORTH
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State | OH
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Zip | 44416-0000
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Country | US
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Telephone | 330-533-2288
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Fax | 330-533-8467
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Provider Business Mailing Address
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Address Line | PO BOX 60 10808 AKRON-CANFIELD RD
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City | ELLSWORTH
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State | OH
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Zip | 44416-0060
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Country | US
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Telephone | 330-533-2288
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Fax | 330-533-8467
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. VANESSA A PELLIN
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Credential | PARAMEDIC
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Telephone | 330-533-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 500052
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License Number State | OH
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