Provider Demographics
NPI:1093974628
Name:SAFECARE AMBULANCE SERVICES INC
Entity Type:Organization
Organization Name:SAFECARE AMBULANCE SERVICES INC
Other - Org Name:NETWORK AMBULANCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOLLENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-764-8803
Mailing Address - Street 1:300 DOMINO LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4352
Mailing Address - Country:US
Mailing Address - Phone:215-764-8803
Mailing Address - Fax:215-827-5608
Practice Address - Street 1:1601 BOULEVARD AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08110-4011
Practice Address - Country:US
Practice Address - Phone:215-764-8803
Practice Address - Fax:215-827-5608
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAFECARE AMBULANCE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSAFCA0043416L0300X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8737606Medicaid
NJ068925Medicare PIN