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General NPI Number Information
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NPI Number | 1043503428
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Entity Type | Organization
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Legal Business Name | TRISTATE AMBULANCE INC
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 12301 MCNULTY RD UNIT B
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City | PHILADELPHIA
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State | PA
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Zip | 19154-1000
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Country | US
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Telephone | 267-334-6269
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Fax |
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Provider Business Mailing Address
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Address Line | 72 BELLWOOD DR
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City | FEASTERVILLE TREVOSE
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State | PA
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Zip | 19053-7215
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Country | US
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Telephone | 267-334-6269
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Fax | 888-316-5731
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Authorized Official
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Title or Position | MANAGER
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Name | LEON BELOV
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Credential |
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Telephone | 267-334-6269
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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 | 11024
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License Number State | PA
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