Provider Demographics
NPI:1407455074
Name:MEDISIST INC.
Entity Type:Organization
Organization Name:MEDISIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:804-200-3974
Mailing Address - Street 1:6001 PLEASANT POND PL
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9210
Mailing Address - Country:US
Mailing Address - Phone:804-480-3200
Mailing Address - Fax:804-480-3202
Practice Address - Street 1:6001 PLEASANT POND PL
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-9210
Practice Address - Country:US
Practice Address - Phone:804-480-3200
Practice Address - Fax:804-480-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)