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General NPI Number Information
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NPI Number | 1629344783
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Entity Type | Organization
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Legal Business Name | SPIRIT EMS LLC
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Dates
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Enumeration Date | 03/22/2012
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 3605 MCCARTY LN STE A
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City | LAFAYETTE
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State | IN
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Zip | 47905-4987
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Country | US
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Telephone | 765-607-2113
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Fax | 765-838-0066
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Provider Business Mailing Address
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Address Line | PO BOX 2128
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City | WEST LAFAYETTE
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State | IN
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Zip | 47996-2128
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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 | CEO
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Name | JEREMY LAWLEY
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Credential |
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Telephone | 765-607-2113
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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 |
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License Number State |
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