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General NPI Number Information
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NPI Number | 1669720181
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Entity Type | Organization
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Legal Business Name | NEW TRINITY AMBULANCE LLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 10/09/2013
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Provider Practice Location Address
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Address Line | 4545 N FRONT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-1606
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Country | US
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Telephone | 215-514-6297
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Fax | 215-613-5652
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Provider Business Mailing Address
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Address Line | 4545 N FRONT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-1606
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Country | US
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Telephone | 215-514-6297
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Fax | 215-613-5652
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONALD H HUMPHREY
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Credential | EMT
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Telephone | 215-514-6297
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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 | 12033
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License Number State | PA
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