Healthcare Provider Details

I. General information

NPI: 1598938839
Provider Name (Legal Business Name): SAMARITAN EMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 SPRAGUE ST
HYDE PARK MA
02136-2061
US

IV. Provider business mailing address

82 CONCORD ST 3RD FLOOR
FRAMINGHAM MA
01702-8304
US

V. Phone/Fax

Practice location:
  • Phone: 617-548-1096
  • Fax:
Mailing address:
  • Phone: 617-997-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3012
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number3012
License Number StateMA

VIII. Authorized Official

Name: MR. ANTHONY JOSEPH CHIANCA
Title or Position: PRESIDENT
Credential:
Phone: 617-997-6125