Healthcare Provider Details
I. General information
NPI: 1639157985
Provider Name (Legal Business Name): AMERICAN PATRIOT AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2006
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13430 DAMAR DR
PHILADELPHIA PA
19116-1801
US
IV. Provider business mailing address
PO BOX 51303
PHILADELPHIA PA
19115-6303
US
V. Phone/Fax
- Phone: 215-677-7800
- Fax: 215-677-7801
- Phone: 215-677-7800
- Fax: 215-677-7801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 04072 |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
ADI
KRONFELD
Title or Position: PRESIDENT
Credential:
Phone: 215-677-7800