Healthcare Provider Details

I. General information

NPI: 1922053420
Provider Name (Legal Business Name): ALTERNATIVE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 13TH AVE BLDG 1
PROSPECT PARK PA
19076-1219
US

IV. Provider business mailing address

660 13TH AVE BLDG 1
PROSPECT PARK PA
19076-1219
US

V. Phone/Fax

Practice location:
  • Phone: 610-583-5064
  • Fax: 610-583-5074
Mailing address:
  • Phone: 610-583-5064
  • Fax: 610-583-5074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03079
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: NATHAN A GLAZER
Title or Position: BILLING MANAGER
Credential: MBA
Phone: 610-583-5064