Provider Demographics
NPI:1841253473
Name:MED EVAC, INC.
Entity type:Organization
Organization Name:MED EVAC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GRISWOLD
Authorized Official - Suffix:III
Authorized Official - Credentials:MBA, RRT, EMT
Authorized Official - Phone:813-633-3822
Mailing Address - Street 1:PO BOX 2079
Mailing Address - Street 2:
Mailing Address - City:MANGO
Mailing Address - State:FL
Mailing Address - Zip Code:33550-2079
Mailing Address - Country:US
Mailing Address - Phone:813-633-3822
Mailing Address - Fax:
Practice Address - Street 1:10122 DOUGLAS OAKS CIRCLE
Practice Address - Street 2:E FRANK GRISWOLD III, MBA, RRT, EMT# 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-8623
Practice Address - Country:US
Practice Address - Phone:813-633-3822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2920341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE5665Medicare ID - Type Unspecified