Healthcare Provider Details

I. General information

NPI: 1235162520
Provider Name (Legal Business Name): AM-VAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 MARLBORO RD
LOTHIAN MD
20711-9541
US

IV. Provider business mailing address

3120 LORD BALTIMORE DR STE 211
WINDSOR MILL MD
21244-2664
US

V. Phone/Fax

Practice location:
  • Phone: 301-952-1193
  • Fax: 301-952-0302
Mailing address:
  • Phone: 410-602-4007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number56
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number2275
License Number StateMD

VIII. Authorized Official

Name: MR. WILLIAM ROSENBERG
Title or Position: CEO
Credential:
Phone: 410-753-1831