=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922053420
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALTERNATIVE TRANSPORT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 660 13TH AVE BLDG 1
-----------------------------------------------------
City | PROSPECT PARK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19076-1219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-583-5064
-----------------------------------------------------
Fax | 610-583-5074
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 660 13TH AVE BLDG 1
-----------------------------------------------------
City | PROSPECT PARK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19076-1219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-583-5064
-----------------------------------------------------
Fax | 610-583-5074
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | NATHAN A GLAZER
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 610-583-5064
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 03079
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------