Provider Demographics
NPI:1336458629
Name:1ST ADVANCED EMS LLC
Entity Type:Organization
Organization Name:1ST ADVANCED EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYUDMILA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KIMKHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-348-9991
Mailing Address - Street 1:723 N JAMES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1839
Mailing Address - Country:US
Mailing Address - Phone:614-348-9991
Mailing Address - Fax:614-348-9991
Practice Address - Street 1:723 N JAMES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1839
Practice Address - Country:US
Practice Address - Phone:614-348-9991
Practice Address - Fax:614-348-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2500123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport