Provider Demographics
NPI:1164408050
Name:UPPER PERKIOMEN VALLEY AMBULANCE CORPS
Entity Type:Organization
Organization Name:UPPER PERKIOMEN VALLEY AMBULANCE CORPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:EISENHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-679-5989
Mailing Address - Street 1:2199 E BUCK ROAD
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073
Mailing Address - Country:US
Mailing Address - Phone:215-679-5989
Mailing Address - Fax:215-679-3295
Practice Address - Street 1:2199 E BUCK RD
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1214
Practice Address - Country:US
Practice Address - Phone:215-679-5989
Practice Address - Fax:215-679-3295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA46032341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance