1346596442 NPI number — EXPRESS AMBULANCE SERVICES INC

Table of content: (NPI 1346596442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346596442 NPI number — EXPRESS AMBULANCE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXPRESS AMBULANCE SERVICES 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:
1346596442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
605 EDISON AVE
Provider Second Line Business Mailing Address:
UNIT I
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19116-1259
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-546-6721
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
309 CAMER DR
Provider Second Line Business Practice Location Address:
UNIT 2
Provider Business Practice Location Address City Name:
BENSALEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19020-7323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-900-5824
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BOICHENKO
Authorized Official First Name:
DMITRY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
267-546-6721

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)





Copyright © 2007-2024 www.npivalidator.com