Healthcare Provider Details

I. General information

NPI: 1912952821
Provider Name (Legal Business Name): AMERICAN PATIENT TRANSPORT SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E HOLLY ST
HAZLETON PA
18201-5507
US

IV. Provider business mailing address

119 E HOLLY ST P O BOX 652
HAZLETON PA
18201-5507
US

V. Phone/Fax

Practice location:
  • Phone: 570-453-1445
  • Fax:
Mailing address:
  • Phone: 570-453-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number03063
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0018084820002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: DR. WILLIAM PAVLICK
Title or Position: PRESIDENT
Credential:
Phone: 570-453-1445