Provider Demographics
NPI:1114919396
Name:CETRONIA AMBULANCE CORPS, INC
Entity Type:Organization
Organization Name:CETRONIA AMBULANCE CORPS, INC
Other - Org Name:CETRONIA AMBULANCE CORPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:MATEFF
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:610-398-0239
Mailing Address - Street 1:4300 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9564
Mailing Address - Country:US
Mailing Address - Phone:610-398-0239
Mailing Address - Fax:610-395-5028
Practice Address - Street 1:4300 BROADWAY
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9564
Practice Address - Country:US
Practice Address - Phone:610-398-0239
Practice Address - Fax:610-395-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03177341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007323700008Medicaid
PA0007323700009Medicaid