1932367141 NPI number — EMPIRE AMBULANCE INCORPORATED

Table of content: (NPI 1932367141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932367141 NPI number — EMPIRE AMBULANCE INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPIRE AMBULANCE INCORPORATED
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:
1932367141
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
651 HOYT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGDON VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19006-8103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-947-6534
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1987 PIONEER RD
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:
19006-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-938-5999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
VITER
Authorized Official First Name:
ROSTYSLAV
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
267-939-1742

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  08005 , 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)

  • Identifier: 1022273660001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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