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NPI 1851756365

NPI 1851756365 : EXPRESS MEDICAL TRANSPORT, LLC : HOLLAND, PA

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General NPI Number Information
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    NPI Number           |    1851756365
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    Entity Type          |    Organization 
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    Legal Business Name  |    EXPRESS MEDICAL TRANSPORT, LLC 
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Dates
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    Enumeration Date     |    12/28/2015
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    Last Update Date     |    12/28/2015
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Provider Practice Location Address
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    Address Line         |    2183 E VILLAGE RD 
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    City                 |    HOLLAND
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    State                |    PA
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    Zip                  |    18966-2932
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    Country              |    US
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    Telephone            |    267-304-4997
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2183 E VILLAGE RD 
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    City                 |    HOLLAND
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    State                |    PA
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    Zip                  |    18966-2932
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    Country              |    US
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    Telephone            |    267-304-4997
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGING MEMBER
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    Name                 |    MS. IRINA  BEZPALAIA 
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    Credential           |    
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    Telephone            |    267-304-4997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    341600000X
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    Taxonomy Name        |    Ambulance
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    License Number       |    
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    License Number State |    
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