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Organization

SPIRIT MEDICAL TRANSPORT, LLC

Active
Parent organization
SPIRIT MEDICAL TRANSPORT, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SPIRIT MEDICAL TRANSPORT, LLC
Authorized official
MR. BRIAN K. HATHAWAY (CO-OWNER/OPERATOR)
(937) 548-2800
Entity
Organization

Contact information

Practice address
5484 OHIO ROUTE 49 SOUTH, GREENVILLE, OH 45331-1031
(937) 548-2800
(937) 548-2826
Mailing address
5484 OHIO ROUTE 49 SOUTH, GREENVILLE, OH 45331-1031
(937) 548-2800
(937) 548-2826

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
190062
OH
341600000X
Ambulance
343900000X
Non-emergency Medical Transport (VAN)
195055
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2737757
OH
05
2740421
OH
Enumeration date
10/23/2006
Last updated
09/30/2011
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