M & M Medivan

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

200022 Issued in OH

Legal business name

M & M MEDIVAN

Practice address

25288 Elliott Rd
Defiance, OH 43512-9003

Phone

(419) 782-8434

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Kaemming

Title

Director and Owner

Phone

(419) 782-8434

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1730219213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435120024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25288 ELLIOTT RD",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435129003",
            "telephone_number": "419-782-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & M MEDIVAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "KAEMMING",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR AND OWNER",
        "authorized_official_telephone_number": "419-782-8434",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "200022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0595164",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Michael Lucas, M.D.
• Tamara Lucas, CDCA
• Matthew Alan Luthi, ATC
• Luxottica Retail North America Inc
• Jennifer Ann Lydy
• Sarah Maenle, MS CCC-SLP
• Majestic Care of Defiance LLC
• Anne Mallett, LISW-S
• April Elaine Manz, PTA
• Kaylee Marihugh

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.