MEDICARE: TRI-MEDIC INC

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	341600000X	Ambulance	409296	CA

General Provider Information

NPI Number	:	1659604734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-MEDIC INC

Provider Business Mailing Address
First Line	:	9602 S CENTRAL AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90002-2027
Country	:	US
Telephone Number	:	323-732-9156
Fax Number	:	323-293-4514

Provider Business Practice Location Address
First Line	:	9602 S CENTRAL AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90002-2027
Country	:	US
Telephone Number	:	323-732-9156
Fax Number	:	323-292-4514

Authorized Official
Title or Position	:	TREASURER
Name	:	MRS. LA JUNE OWENS
Credential	:
Telephone Number	:	323-732-9156

Provider Enumeration Date	:	09/08/2009
Last Update Date	:	09/08/2009

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Directions to “TRI-MEDIC INC ” Practice Location

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