MEDICARE: MOBILE CARE TRANSPORT

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	:	1861782948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE CARE TRANSPORT

Provider Business Mailing Address
First Line	:	PO BOX 3668
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-0668
Country	:	US
Telephone Number	:	215-425-1900
Fax Number	:	215-425-2900

Provider Business Practice Location Address
First Line	:	1918 E WESTMORELAND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-2522
Country	:	US
Telephone Number	:	215-425-1900
Fax Number	:	215-425-2900

Authorized Official
Title or Position	:	MEMBER
Name	:	JOSE NUNEZ
Credential	:
Telephone Number	:	215-425-1900

Provider Enumeration Date	:	04/11/2011
Last Update Date	:	09/03/2014

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Directions to “MOBILE CARE TRANSPORT ” Practice Location

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