Healthcare Provider Details

I. General information

NPI: 1932574860
Provider Name (Legal Business Name): EASTERNCARE AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 WICKER AVE
BENSALEM PA
19020-7251
US

IV. Provider business mailing address

727 WICKER AVE
BENSALEM PA
19020-7251
US

V. Phone/Fax

Practice location:
  • Phone: 215-331-9911
  • Fax: 215-331-9912
Mailing address:
  • Phone: 215-331-9911
  • Fax: 215-331-9912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number09091
License Number StatePA

VIII. Authorized Official

Name: DAMON WAADE
Title or Position: COO
Credential:
Phone: 215-331-9911