MEDICARE: PENN MEDICAL EMS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1093493959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENN MEDICAL EMS LLC

Provider Business Mailing Address
First Line	:	2515 N FRONT ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-1150
Country	:	US
Telephone Number	:	717-831-2941
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 N MOUNTAIN RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2616
Country	:	US
Telephone Number	:	717-572-3214
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. YAZAN HASSAN
Credential	:
Telephone Number	:	717-831-2941

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/11/2023

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Directions to “PENN MEDICAL EMS LLC ” Practice Location

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