Healthcare Provider Details

I. General information

NPI: 1306918206
Provider Name (Legal Business Name): A-1 AMBULANCE & TRANSPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7529 OLD ALEXANDRIA FERRY RD # A
CLINTON MD
20735-1835
US

IV. Provider business mailing address

PO BOX 835
CHARLOTTE HALL MD
20622-0835
US

V. Phone/Fax

Practice location:
  • Phone: 240-318-0333
  • Fax: 240-318-0336
Mailing address:
  • Phone: 240-318-0333
  • Fax: 240-318-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number073
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number503
License Number StateMD

VIII. Authorized Official

Name: MR. BRIAN EASTER SR.
Title or Position: VICE PRESIDENT
Credential:
Phone: 240-318-0333