Organization
M & M MEDIVAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY KAEMMING (DIRECTOR AND OWNER)
(419) 782-8434
Entity
Organization
Contact information
Practice address
25288 ELLIOTT RD, DEFIANCE, OH 43512-9003
(419) 782-8434
Mailing address
PO BOX 24, DEFIANCE, OH 43512-0024
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
200022
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0595164
—
OH
Enumeration date
03/06/2007
Last updated
02/19/2019
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