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General NPI Number Information
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NPI Number | 1003979444
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Entity Type | Organization
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Legal Business Name | HAVRE DE GRACE AMBULANCE CORPS INC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 1601 LEVEL RD
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City | HAVRE DE GRACE
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State | MD
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Zip | 21078-1727
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Country | US
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Telephone | 410-939-6658
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 465
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City | HAVRE DE GRACE
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State | MD
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Zip | 21078-0465
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Country | US
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Telephone | 410-939-6658
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK HEMLER
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Credential |
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Telephone | 410-939-6658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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