Provider Demographics
NPI:1346937562
Name:THE SERVIAM GROUP LLC
Entity Type:Organization
Organization Name:THE SERVIAM GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ORSBURN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:JR
Authorized Official - Credentials:NREMT
Authorized Official - Phone:813-759-3283
Mailing Address - Street 1:2406 E STATE ROAD 60 UNIT 1528
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33595-8063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:911 S WOODROW WILSON ST STE 23
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-9304
Practice Address - Country:US
Practice Address - Phone:813-836-9601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport