KLG Mobile Intensive Co LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

150062 Issued in OH

Legal business name

KLG MOBILE INTENSIVE CO LLC

Practice address

1516 B South Lincoln Avenue
Salem, OH 44460-4249

Phone

(330) 337-4555

Fax

(330) 337-4552

NPI assigned

Apr 20, 2006

Last updated

Mar 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Karl Lee Griggs

Title

President Ceo

Phone

(330) 337-4555

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1952367807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 B SOUTH LINCOLN AVENUE",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444604249",
            "telephone_number": "330-337-4555",
            "fax_number": "330-337-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 B SOUTH LINCOLN AVENUE",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444604249",
            "telephone_number": "330-337-4555",
            "fax_number": "330-337-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLG MOBILE INTENSIVE CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "GRIGGS",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "330-337-4555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OH",
            "license": "150062",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "155075",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2181071",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.