Basic Information
| Provider Information | |||||||||
| NPI: | 1023439981 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMERGENCY PROFESSIONAL SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7123 PEARL RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441304944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408427990 | ||||||||
| FaxNumber: | 4408428835 | ||||||||
| Practice Location | |||||||||
| Address1: | 2351 E 22ND ST | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441153111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168616200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2013 | ||||||||
| LastUpdateDate: | 12/19/2013 | ||||||||
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| AuthorizedOfficialLastName: | DOLLISON | ||||||||
| AuthorizedOfficialFirstName: | LAUREL | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4408427990 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 146D00000X | 50003853 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Emergency Medical Service Providers | Personal Emergency Response Attendant |
No ID Information.