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General NPI Number Information
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NPI Number | 1477738805
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Entity Type | Organization
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Legal Business Name | GREY EAGLE INC.
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 550 STATE RD SUITE 102
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City | BENSALEM
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State | PA
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Zip | 19020-8700
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Country | US
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Telephone | 215-244-4500
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Fax | 215-244-4577
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Provider Business Mailing Address
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Address Line | 550 STATE RD SUITE 102
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City | BENSALEM
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State | PA
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Zip | 19020-8700
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Country | US
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Telephone | 215-244-4500
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Fax | 215-244-4577
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BORIS ROSTOVSKY
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Credential |
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Telephone | 610-517-4008
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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 | 07023
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License Number State | PA
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