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General NPI Number Information
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NPI Number | 1376726489
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Entity Type | Organization
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Legal Business Name | ADVANTAGE AMBULANCE INC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 4401 E FAIRMOUNT AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-1703
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Country | US
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Telephone | 410-534-5200
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Fax | 410-534-5201
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Provider Business Mailing Address
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Address Line | 4401 E FAIRMOUNT AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-1703
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Country | US
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Telephone | 410-534-5200
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Fax | 410-534-5201
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZAHAR TKACH
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Credential |
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Telephone | 410-534-5200
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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 | 124
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License Number State | MD
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