Provider Demographics
NPI:1093034167
Name:MEDEVENT911 LLC
Entity type:Organization
Organization Name:MEDEVENT911 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:MCCLUSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:CEP
Authorized Official - Phone:623-322-1908
Mailing Address - Street 1:16772 W BELL RD
Mailing Address - Street 2:SUITE 110-274
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9702
Mailing Address - Country:US
Mailing Address - Phone:623-322-1908
Mailing Address - Fax:480-247-5512
Practice Address - Street 1:16772 W BELL RD
Practice Address - Street 2:SUITE 110-274
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9702
Practice Address - Country:US
Practice Address - Phone:623-322-1908
Practice Address - Fax:480-247-5512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty