{
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"OrgName": "EMERGENCY TRANSPORT ASSOCIATES INC",
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"FirstLineMailingAddress": "PO BOX 8500-51695",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19178-0001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "111 S 11TH ST",
"SecondLinePracticeLocationAddress": "SUITE 2130",
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-955-2700",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/29/2006",
"LastUpdateDate": "09/28/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SWEENEY",
"AuthorizedOfficialFirstName": "BRIAN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "215-955-7937",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "04295",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}