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General NPI Number Information
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NPI Number | 1346372562
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Entity Type | Organization
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Legal Business Name | MIDATLANTIC MEDEVAC LLC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 230 NORTH BROAD STREET SUITE 487
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1192
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Country | US
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Telephone | 215-762-4713
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Fax | 215-762-1803
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Provider Business Mailing Address
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Address Line | PO BOX 822356
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City | PHILADELPHIA
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State | PA
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Zip | 19182
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Country | US
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Telephone | 215-762-4713
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Fax | 215-762-1803
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. HAL SPATZ
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Credential |
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Telephone | 215-762-4713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number | 02134
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License Number State | PA
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