MEDICARE: MERCURY EMS CONSULTANTS 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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1679277677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCURY EMS CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	808 E FRANKLIN ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-5605
Country	:	US
Telephone Number	:	937-640-3502
Fax Number	:

Provider Business Practice Location Address
First Line	:	808 E FRANKLIN ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-5605
Country	:	US
Telephone Number	:	937-640-3502
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID ASTORGA
Credential	:	PARAMEDIC
Telephone Number	:	937-640-3502

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/10/2026

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Directions to “MERCURY EMS CONSULTANTS LLC ” Practice Location

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