Healthcare Provider Details

I. General information

NPI: 1538356563
Provider Name (Legal Business Name): CARDIOCARE AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

781 MOCKINGBIRD LN
AUDUBON PA
19403-1917
US

IV. Provider business mailing address

781 MOCKINGBIRD LN
AUDUBON PA
19403-1917
US

V. Phone/Fax

Practice location:
  • Phone: 484-636-9454
  • Fax:
Mailing address:
  • Phone: 484-636-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number07014
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number07014
License Number StatePA

VIII. Authorized Official

Name: MILAN PATEL
Title or Position: PRESIDENT/OWNER
Credential: EMT
Phone: 484-636-9454