Provider Demographics
NPI:1063484418
Name:J&K HALDEMAN, LLC
Entity Type:Organization
Organization Name:J&K HALDEMAN, LLC
Other - Org Name:STAT CARE AMBULANCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HALDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:610-255-5915
Mailing Address - Street 1:117 GLENLOCH DR
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-9663
Mailing Address - Country:US
Mailing Address - Phone:610-255-5915
Mailing Address - Fax:610-255-2455
Practice Address - Street 1:117 GLENLOCH DR
Practice Address - Street 2:
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-9663
Practice Address - Country:US
Practice Address - Phone:610-255-5915
Practice Address - Fax:610-255-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15203341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30023732OtherKEYSTONE MERCY
PA076200OtherBC/BS
PA0197493902Medicaid
PA076200Medicare ID - Type Unspecified