# MEDCORP EMS SOUTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154399137
- **Authorized official:** MR. RICHARD BAGE (PRESIDENT/CEO)
- **Authorized official phone:** (419) 727-7000

## Contact information

- **Practice address:** 745 MEDCORP DR, TOLEDO, OH 43608-1376
- **Practice address phone:** (419) 727-7000
- **Practice address fax:** (419) 729-6411
- **Mailing address:** 745 MEDCORP DR, TOLEDO, OH 43608-1376
- **Mailing address phone:** (419) 727-7000
- **Mailing address fax:** (419) 729-6411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416A0800X | Air Ambulance | 1676 | KY | — |
| 3416L0300X | Land Ambulance | 1271 | KY | Yes |
| 3416L0300X | Land Ambulance | 480382 | OH | — |
| 3416S0300X | Water Ambulance | 1657 | KY | — |
| 343900000X | Non-emergency Medical Transport (VAN) | N/A | OH | — |
| 347B00000X | Bus | 1677 | KY | — |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 11/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2613130 | — | OH |
| 05 | — | 55001382 | — | KY |
| 05 | — | 56031065 | — | KY |