Healthcare Provider Details
I. General information
NPI: 1548247455
Provider Name (Legal Business Name): KEYSTONE QUALITY TRANSPORT COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2005
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1260 E WOODLAND AVE SUITE 220
SPRINGFIELD PA
19064-3969
US
IV. Provider business mailing address
PO BOX 2027
MEDIA PA
19063-9027
US
V. Phone/Fax
- Phone: 610-541-6610
- Fax: 610-541-6624
- Phone: 610-541-6610
- Fax: 610-541-6624
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 23209 |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
DANNY
PLATT
Title or Position: CEO
Credential:
Phone: 610-566-2200