Organization
MEDCORP EMS SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD BAGE (PRESIDENT/CEO)
(419) 727-7000
Entity
Organization
Contact information
Practice address
745 MEDCORP DR, TOLEDO, OH 43608-1376
(419) 727-7000
(419) 729-6411
Mailing address
745 MEDCORP DR, TOLEDO, OH 43608-1376
(419) 727-7000
(419) 729-6411
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
1676
KY
3416L0300X
Land Ambulance
Primary
1271
KY
3416L0300X
Land Ambulance
480382
OH
3416S0300X
Water Ambulance
1657
KY
343900000X
Non-emergency Medical Transport (VAN)
N/A
OH
347B00000X
Bus
1677
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2613130
—
OH
05
—
55001382
—
KY
05
—
56031065
—
KY
Enumeration date
03/08/2006
Last updated
11/07/2011
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