Provider Demographics
NPI:1023193810
Name:MOBILE EMS, INC.
Entity Type:Organization
Organization Name:MOBILE EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-247-3000
Mailing Address - Street 1:4167 MEGHAN BEELER CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-8409
Mailing Address - Country:US
Mailing Address - Phone:574-247-3000
Mailing Address - Fax:574-247-4552
Practice Address - Street 1:4167 MEGHAN BEELER CT
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-8409
Practice Address - Country:US
Practice Address - Phone:574-247-3000
Practice Address - Fax:574-247-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71-0932341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN239220Medicare ID - Type Unspecified
IN1023193810Medicare UPIN