Provider Demographics
NPI:1730657255
Name:PHYSICIANS AMBULANCE SERVICE 2 LLC
Entity Type:Organization
Organization Name:PHYSICIANS AMBULANCE SERVICE 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-444-6212
Mailing Address - Street 1:274 HIGHWAY 44 E UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8051
Mailing Address - Country:US
Mailing Address - Phone:317-746-6428
Mailing Address - Fax:502-531-0103
Practice Address - Street 1:4038 PARK 65 DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2500
Practice Address - Country:US
Practice Address - Phone:317-481-9000
Practice Address - Fax:502-481-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN429398OtherDOT