Organization
PC ON BOARD, LLC
Active
Other names
HART'S AMBULETTE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAUREY C MEDVICK-TATE (OWNER)
(419) 332-3911
Entity
Organization
Contact information
Practice address
3134 E STATE ST, FREMONT, OH 43420-9280
(419) 332-3911
(419) 332-3820
Mailing address
3134 E STATE ST, FREMONT, OH 43420-9280
(419) 332-3911
(419) 332-3820
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
MTB-1051
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2549871
—
OH
01
—
61101
HUMANA
KY
01
—
734548
BUCKYE COMMUNITY HEALTH
OH
Enumeration date
03/31/2006
Last updated
04/25/2013
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