MEDICARE: PHOENIX PARAMEDIC SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	429362	OTHER	IN	MOTOR CARRIER
2	1250	OTHER	IN	STATE EMS COMMSION: EMS PROVIDER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184273450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX PARAMEDIC SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	1600 KEPNER DR STE E
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-7436
Country	:	US
Telephone Number	:	765-448-4327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 KEPNER DR STE E
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-7436
Country	:	US
Telephone Number	:	765-448-4327
Fax Number	:	765-448-4694

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	NATHANIEL A METZ
Credential	:
Telephone Number	:	765-448-4327

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	09/23/2019

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Directions to “PHOENIX PARAMEDIC SOLUTIONS, LLC ” Practice Location

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