1912204793 NPI number — HEALTH PARTNER AMBULANCE INC.

Table of content: (NPI 1912204793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912204793 NPI number — HEALTH PARTNER AMBULANCE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH PARTNER AMBULANCE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912204793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10843 LOCKART RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19116-3133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-597-4614
Provider Business Mailing Address Fax Number:
215-677-1425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 TOMLINSON RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGDON VALLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19006-4251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-597-4614
Provider Business Practice Location Address Fax Number:
215-677-1425
Provider Enumeration Date:
02/14/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZUBACH
Authorized Official First Name:
OLEG
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
267-597-4614

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  11004 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)