Healthcare Provider Details

I. General information

NPI: 1356524714
Provider Name (Legal Business Name): HEALTHATLANTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2007
Last Update Date: 03/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BULLTOWN RD
ELVERSON PA
19520
US

IV. Provider business mailing address

PO BOX 74
ELVERSON PA
19520-0074
US

V. Phone/Fax

Practice location:
  • Phone: 800-789-0912
  • Fax: 610-927-6339
Mailing address:
  • Phone: 800-789-0912
  • Fax: 610-927-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number07001
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number07001
License Number StatePA

VIII. Authorized Official

Name: TROY BARLET
Title or Position: EXEC MANAGER
Credential: EMT
Phone: 800-789-0912