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General NPI Number Information
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NPI Number | 1336701358
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Entity Type | Organization
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Legal Business Name | TRI STATE EMS LLC
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Dates
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Enumeration Date | 06/29/2019
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1391 EASTON RD
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City | ABINGTON
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State | PA
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Zip | 19001-2453
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Country | US
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Telephone | 610-504-5464
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Fax | 610-549-7449
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Provider Business Mailing Address
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Address Line | PO BOX 18533
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City | PITTSBURGH
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State | PA
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Zip | 15236-0533
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Country | US
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Telephone | 610-246-6908
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Fax | 724-234-4703
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | ALEXANDER ORION KVETAN
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Credential |
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Telephone | 610-504-5464
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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 |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 1037289730001
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 1037289730001
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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