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General NPI Number Information
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NPI Number | 1558638122
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Entity Type | Organization
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Legal Business Name | STAT ONE AMBULANCE
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Dates
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Enumeration Date | 11/25/2011
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Last Update Date | 11/25/2011
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Provider Practice Location Address
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Address Line | 99 CHESTER PIKE
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City | DARBY
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State | PA
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Zip | 19023-2035
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Country | US
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Telephone | 800-825-4182
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Fax |
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Provider Business Mailing Address
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Address Line | 6148 REACH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19111-5926
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Country | US
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Telephone | 800-825-4182
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARVIN D WHITE
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Credential |
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Telephone | 800-825-4182
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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 | 11019
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License Number State | PA
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