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General NPI Number Information
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NPI Number | 1992574388
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Entity Type | Organization
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Legal Business Name | CHARTER AMBULANCE TRANSPORT LLC
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Dates
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Enumeration Date | 12/27/2023
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 401 E BROADWAY STE 1
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City | RED LION
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State | PA
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Zip | 17356-8856
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Country | US
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Telephone | 717-954-5853
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Fax |
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Provider Business Mailing Address
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Address Line | 113 PENNY LN
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City | NEW FREEDOM
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State | PA
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Zip | 17349-9450
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KEVIN COPELAND
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Credential |
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Telephone | 717-858-8477
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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 |
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License Number State |
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Taxonomy #2
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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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