1922053420 NPI number — ALTERNATIVE TRANSPORT LLC

Table of content: (NPI 1922053420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922053420 NPI number — ALTERNATIVE TRANSPORT LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTERNATIVE TRANSPORT LLC
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:
1922053420
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 13TH AVE
Provider Second Line Business Mailing Address:
BLDG 1
Provider Business Mailing Address City Name:
PROSPECT PARK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19076-1219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-583-5064
Provider Business Mailing Address Fax Number:
610-583-5074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 13TH AVE
Provider Second Line Business Practice Location Address:
BLDG 1
Provider Business Practice Location Address City Name:
PROSPECT PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19076-1219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-583-5064
Provider Business Practice Location Address Fax Number:
610-583-5074
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GLAZER
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
610-583-5064

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  03079 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0000206000 . This is a "INDEPEN BLUE CROSS PROV #" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
  • Identifier: 1110183 . This is a "KEYSTONE MERCY PROV NMBR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 33278 . This is a "HEALTH PARTNERS PROV NUMB" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com