1023388139 NPI number — COMFORT AMBULANCE

Table of content: (NPI 1023388139)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023388139 NPI number — COMFORT AMBULANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMFORT AMBULANCE
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:
COMFORT AMBULANCE INC
Provider Other Organization Name Type Code:
4
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:
1023388139
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2179 BENNETT RD
Provider Second Line Business Mailing Address:
UNIT B
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19116-3021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-821-8238
Provider Business Mailing Address Fax Number:
215-464-5666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2179 BENNETT RD
Provider Second Line Business Practice Location Address:
UNIT B
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19116-3021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-821-8238
Provider Business Practice Location Address Fax Number:
215-464-5666
Provider Enumeration Date:
01/05/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TESA
Authorized Official First Name:
ALEX
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
215-821-8238

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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