Provider Demographics
NPI:1548810054
Name:MEDICTEAM LLC
Entity type:Organization
Organization Name:MEDICTEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSTIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PILIP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-737-3330
Mailing Address - Street 1:55 NEW ST STE 20
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-2815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 NEW ST STE 20
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-2815
Practice Address - Country:US
Practice Address - Phone:717-737-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport