Organization
KLG MOBILE INTENSIVE CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KARL LEE GRIGGS (PRESIDENT CEO)
(330) 337-4555
Entity
Organization
Contact information
Practice address
1516 B SOUTH LINCOLN AVENUE, SALEM, OH 44460-4249
(330) 337-4555
(330) 337-4552
Mailing address
1516 B SOUTH LINCOLN AVENUE, SALEM, OH 44460-4249
(330) 337-4555
(330) 337-4552
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
150062
OH
343900000X
Non-emergency Medical Transport (VAN)
155075
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181071
—
OH
Enumeration date
04/20/2006
Last updated
03/09/2012
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