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MEDIC ONE LLC NPI 1114006939


NPI Information

NPI: 1114006939
Provider Name: MEDIC ONE, LLC

Doing Business As: MEDIC ONE AMBULANCE

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 04D2073013

Address:
6007 DALTON FARMER DR
JONESBORO, AR
ZIP 72404
Phone: (870) 972-0708
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MEDIC ONE, LLC is a land transport ambulance in Jonesboro, AR. MEDIC ONE, LLC NPI is 1114006939. The provider is registered as an organization entity type.
The provider Is Doing Business As Medic One Ambulance.

The provider's business location address is:

6007 DALTON FARMER DR
JONESBORO, AR
ZIP 72404-895
Phone: (870) 972-0708

The provider's authorized official is Kim Mann .
The authorized official title is President and has the following contact phone number (870) 972-8484.

The CLIA number assigned to this NPI record is 04D2073013 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 4/15/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13416L0300XAmbulanceLand Transport069132MISSOURIYes
23416L0300XAmbulanceLand TransportNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1806255303MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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