MEDICARE: MEMORIAL EMERGENCY MEDICAL SERVICE 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	:	1811534704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL EMERGENCY MEDICAL SERVICE LLC

Provider Business Mailing Address
First Line	:	2375 REFUGEE PARK
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-2173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 REFUGEE PARK
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-2173
Country	:	US
Telephone Number	:	614-549-7005
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	MOHAMMAD ALHEJJA
Credential	:
Telephone Number	:	770-533-1155

Provider Enumeration Date	:	12/10/2019
Last Update Date	:	12/01/2020

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Directions to “MEMORIAL EMERGENCY MEDICAL SERVICE LLC ” Practice Location

Language	Start Address	Practice Location

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