Provider Demographics
NPI:1033195466
Name:BRADFORD Z-STAT
Entity Type:Organization
Organization Name:BRADFORD Z-STAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ZMUDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-598-8924
Mailing Address - Street 1:26 PIKE ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2347
Mailing Address - Country:US
Mailing Address - Phone:814-598-8924
Mailing Address - Fax:814-368-8675
Practice Address - Street 1:26 PIKE ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2347
Practice Address - Country:US
Practice Address - Phone:814-598-8924
Practice Address - Fax:814-368-8675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-18
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA051873416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014788177Medicaid
PA1808023OtherHIGHMARK BLUE SHIELD
NY02739004Medicaid
PAP00383620OtherRAILROAD MEDICARE
PA098045Medicare PIN