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General NPI Number Information
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NPI Number | 1962975987
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Entity Type | Organization
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Legal Business Name | MEDIC 1
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 1643 OFFNERE ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-3537
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Country | US
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Telephone | 740-821-5531
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 232
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City | SOUTH SHORE
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State | KY
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Zip | 41175-0232
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Country | US
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Telephone | 740-821-5531
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA PAUL BLEVINS
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Credential | EMTP
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Telephone | 740-821-5531
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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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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