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General NPI Number Information
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NPI Number | 1679770549
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Entity Type | Organization
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Legal Business Name | PLATINUM NINE HOLDINGS LLC
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 8115 BROADWAY STE 101
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City | EVERETT
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State | WA
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Zip | 98203-6871
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Country | US
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Telephone | 360-722-9211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 547
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City | WHEELING
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State | IL
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Zip | 60090-0547
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Country | US
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Telephone | 360-722-9211
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOEL HAROLD SMITH
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Credential |
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Telephone | 425-359-0344
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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 | 31X12
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License Number State | WA
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