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General NPI Number Information
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NPI Number | 1821066895
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Entity Type | Organization
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Legal Business Name | MEDCORP INC.
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 745 MEDCORP DR
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City | TOLEDO
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State | OH
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Zip | 43608-1376
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Country | US
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Telephone | 419-727-7000
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Fax | 419-727-8439
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Provider Business Mailing Address
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Address Line | 745 MEDCORP DR
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City | TOLEDO
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State | OH
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Zip | 43608-1376
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Country | US
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Telephone | 419-727-7000
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Fax | 419-727-8439
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. RICHARD BAGE
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Credential |
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Telephone | 419-727-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | 06-C-00579-01
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | N/A
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 480142
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License Number State | OH
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