Medcorp EMS South LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1271 Issued in KY

Legal business name

MEDCORP EMS SOUTH LLC

Practice address

745 Medcorp Dr
Toledo, OH 43608-1376

Phone

(419) 727-7000

Fax

(419) 729-6411

NPI assigned

Mar 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard Bage

Title

President/Ceo

Phone

(419) 727-7000

Specialties & licenses 6

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1154399137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 MEDCORP DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436081376",
            "telephone_number": "419-727-7000",
            "fax_number": "419-729-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 MEDCORP DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436081376",
            "telephone_number": "419-727-7000",
            "fax_number": "419-729-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCORP EMS SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "BAGE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "419-727-7000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "KY",
            "license": "1676",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "480382",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "KY",
            "license": "1271",
            "primary": true
        },
        {
            "code": "3416S0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Water Transport",
            "state": "KY",
            "license": "1657",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": "KY",
            "license": "1677",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2613130",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56031065",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55001382",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Toledo, OH
• Providers in Toledo, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.