Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Air Transport |
3416A0800X | 59 | Ambulance Service Provider |
| NPI # | 1295088029 |
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| LBN Legal business name | EXECMED, LLC | ||||
| Authorized official | DAVID HEDEQUIST - (MEMBER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 10/17/2012 | ||||
| Last updated | 09/12/2013 - About 13 years ago | ||||
| Identifiers |
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