Provider Demographics
NPI:1184962334
Name:EMERGENCY MEDIVAC SERVICES, LLC
Entity type:Organization
Organization Name:EMERGENCY MEDIVAC SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-245-9762
Mailing Address - Street 1:925 B ST
Mailing Address - Street 2:#102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-4616
Mailing Address - Country:US
Mailing Address - Phone:619-342-7408
Mailing Address - Fax:619-342-7410
Practice Address - Street 1:925 B ST
Practice Address - Street 2:#102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-4616
Practice Address - Country:US
Practice Address - Phone:619-342-7408
Practice Address - Fax:610-342-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport