MEDICARE: PRO-TECH AMBULANCE COMPANY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	03064	PA

General Provider Information

NPI Number	:	1811972722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO-TECH AMBULANCE COMPANY, INC.

Provider Business Mailing Address
First Line	:	3325 EDGEMONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-5305
Country	:	US
Telephone Number	:	215-427-9001
Fax Number	:	215-427-9009

Provider Business Practice Location Address
First Line	:	3325 EDGEMONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-5305
Country	:	US
Telephone Number	:	215-427-9001
Fax Number	:	215-427-9009

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT J HORN JR.
Credential	:
Telephone Number	:	215-427-9001

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	12/20/2011

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