Healthcare Provider Details

I. General information

NPI: 1639156623
Provider Name (Legal Business Name): PLYMOUTH COMMUNITY AMBULANCE ASSN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 GERMANTOWN PIKE
PLYMOUTH MEETING PA
19462-7400
US

IV. Provider business mailing address

902 GERMANTOWN PIKE
PLYMOUTH MEETING PA
19462-7400
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-2776
  • Fax: 610-277-8449
Mailing address:
  • Phone: 610-277-2776
  • Fax: 610-277-8449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number46026
License Number StatePA

VIII. Authorized Official

Name: ANDREW M TOMCHO
Title or Position: BILLING MANAGER
Credential:
Phone: 610-277-2776