MEDICARE: MEDHEALTH AMBULANCE INC.

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	3416L0300X	Land Ambulance	03326	PA

General Provider Information

NPI Number	:	1578502852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDHEALTH AMBULANCE INC.

Provider Business Mailing Address
First Line	:	PO BOX 16194
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-0194
Country	:	US
Telephone Number	:	888-363-4900
Fax Number	:	215-676-0665

Provider Business Practice Location Address
First Line	:	2705 BLACK LAKE PL
Second Line	:	STE 300
City	:	PHILADELPHIA
State	:	PA
Zip	:	19154-1010
Country	:	US
Telephone Number	:	888-363-4900
Fax Number	:	215-676-0665

Authorized Official
Title or Position	:	CEO
Name	:	MR. JEFFREY STEZEN
Credential	:
Telephone Number	:	888-363-4900

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	08/22/2020

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