Healthcare Provider Details

I. General information

NPI: 1144379025
Provider Name (Legal Business Name): KUTZTOWN AREA TRANSPORT SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 S KEMP RD
KUTZTOWN PA
19530-9737
US

IV. Provider business mailing address

87 S KEMP RD
KUTZTOWN PA
19530-9737
US

V. Phone/Fax

Practice location:
  • Phone: 610-683-3012
  • Fax: 610-683-9161
Mailing address:
  • Phone: 610-683-3012
  • Fax: 610-683-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number05061
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number05061
License Number StatePA

VIII. Authorized Official

Name: REBECCA A RAKOWIECKI
Title or Position: PRESIDENT
Credential:
Phone: 610-683-3012