Provider Demographics
NPI:1003198003
Name:FAMILY MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:FAMILY MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-331-3945
Mailing Address - Street 1:141 E GLENSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4602
Mailing Address - Country:US
Mailing Address - Phone:215-884-1718
Mailing Address - Fax:215-886-1916
Practice Address - Street 1:141 E GLENSIDE AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4602
Practice Address - Country:US
Practice Address - Phone:215-884-1718
Practice Address - Fax:215-886-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA110743416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport