Provider Demographics
NPI:1801316567
Name:EDISA PARAMEDICS TRANSPORTATION, LLC
Entity type:Organization
Organization Name:EDISA PARAMEDICS TRANSPORTATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:HECHE
Authorized Official - Last Name:NYANCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:316-821-8639
Mailing Address - Street 1:1100 S ROYAL ROAD
Mailing Address - Street 2:1100 S ROYAL ROAD
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-2840
Mailing Address - Country:US
Mailing Address - Phone:316-821-8639
Mailing Address - Fax:316-613-8059
Practice Address - Street 1:1100 S ROYAL RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-2840
Practice Address - Country:US
Practice Address - Phone:316-821-8639
Practice Address - Fax:316-613-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)