# CLINTON MEDICAL TRANSPORT INC

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

## Provider details

- **NPI number:** 1982778353
- **Authorized official:** LARRY V CHAMBERLAIN (OWNER)
- **Authorized official phone:** (937) 383-2642

## Contact information

- **Practice address:** 1570 W MAIN ST, WILMINGTON, OH 45177-1031
- **Practice address phone:** (937) 383-2642
- **Practice address fax:** (937) 382-8228
- **Mailing address:** PO BOX 766, WILMINGTON, OH 45177-0766
- **Mailing address phone:** (937) 383-2642
- **Mailing address fax:** (937) 382-8228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 140012 | OH | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 04/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0806015 | — | OH |