Healthcare Provider Details

I. General information

NPI: 1831205848
Provider Name (Legal Business Name): RHAWNHURST BUSTLETON AMBULANCE ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 GRANT AVE
PHILADELPHIA PA
19115-4355
US

IV. Provider business mailing address

2044 GRANT AVE
PHILADELPHIA PA
19115-4355
US

V. Phone/Fax

Practice location:
  • Phone: 215-698-9111
  • Fax: 215-698-2918
Mailing address:
  • Phone: 215-698-9111
  • Fax: 215-698-2918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number04075
License Number StatePA

VIII. Authorized Official

Name: MR. SIGMUND JOEL FINE
Title or Position: PRESIDENT
Credential:
Phone: 215-698-9111