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General NPI Number Information
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NPI Number | 1184923294
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Entity Type | Organization
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Legal Business Name | CORNERSTONE MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 311 W ZERALDA ST
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4231
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Country | US
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Telephone | 267-546-8512
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Fax |
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Provider Business Mailing Address
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Address Line | 5219 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2301
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Country | US
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Telephone | 267-546-8512
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. SHAWN HARRIS
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Credential |
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Telephone | 267-546-8512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 11012
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License Number State | PA
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