Healthcare Provider Details
I. General information
NPI: 1396770137
Provider Name (Legal Business Name): DNA AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8351 HEGERMAN ST
PHILADELPHIA PA
19136
US
IV. Provider business mailing address
PO BOX 63416
PHILADELPHIA PA
19114-8416
US
V. Phone/Fax
- Phone: 215-331-8800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 06100 |
| License Number State | PA |
VIII. Authorized Official
Name: MS.
MARIANNA
ARAKELOVA
Title or Position: CEO
Credential:
Phone: 215-331-8800