Organization
MEDEVAC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
E FRANK GRISWOLD III MBA, RRT, EMT (PRESIDENT / CEO)
(813) 633-3822
Entity
Organization
Contact information
Practice address
424 DOWN PINE DRIVE, SEFFNER, FL 33584-3719
(813) 633-3822
Mailing address
PO BOX 654, MANGO, FL 33550-0654
(813) 633-3822
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
—
FL
333300000X
Emergency Response System Companies
Primary
—
—
341600000X
Ambulance
—
FL
3416A0800X
Air Ambulance
—
FL
3416L0300X
Land Ambulance
—
FL
343900000X
Non-emergency Medical Transport (VAN)
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46Y26
FEDERAL CONTRACTOR CAGE CODE
DC
Enumeration date
10/31/2005
Last updated
09/02/2016
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