Provider Demographics
NPI:1346953965
Name:PHOENIX PARAMEDIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PHOENIX PARAMEDIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:METZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-448-4327
Mailing Address - Street 1:3535 MCCARTY LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4985
Mailing Address - Country:US
Mailing Address - Phone:765-237-4129
Mailing Address - Fax:
Practice Address - Street 1:3554 PROMENADE PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-8417
Practice Address - Country:US
Practice Address - Phone:765-637-7161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty