Medic Response Ambulance Service, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

700042 Issued in OH

Legal business name

MEDIC RESPONSE AMBULANCE SERVICE, INC.

Practice address

230 N Mulberry St
Mansfield, OH 44902-1055

Phone

(419) 524-3838

Fax

(419) 774-1799

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Thomas F Wappner

Title

President

Phone

(419) 524-3838

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1679626527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N. MULBERRY ST.",
            "address_2": "P.O. BOX 1514",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449011514",
            "telephone_number": "419-524-3838",
            "fax_number": "419-774-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MULBERRY ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449021055",
            "telephone_number": "419-524-3838",
            "fax_number": "419-774-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC RESPONSE AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "WAPPNER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-524-3838",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "700042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H195570",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0727502",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.