Provider Demographics
NPI:1235162520
Name:AM-VAN INCORPORATED
Entity Type:Organization
Organization Name:AM-VAN INCORPORATED
Other - Org Name:ALL AMERICAN AMBULANCE & TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:301-952-1193
Mailing Address - Street 1:1315 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:LOTHIAN
Mailing Address - State:MD
Mailing Address - Zip Code:20711-9541
Mailing Address - Country:US
Mailing Address - Phone:301-952-1193
Mailing Address - Fax:301-952-1280
Practice Address - Street 1:1315 MARLBORO RD
Practice Address - Street 2:
Practice Address - City:LOTHIAN
Practice Address - State:MD
Practice Address - Zip Code:20711-9541
Practice Address - Country:US
Practice Address - Phone:301-952-1193
Practice Address - Fax:301-952-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD563416L0300X
MD2275343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD182909OtherAETNA HMO
MD8100017OtherEVERCARE
MD906502OtherUNITED HEALTH CARE
MDF4880001OtherCAREFIRST BCBS OF MD/DC
MD059878000Medicaid
DC025272200Medicaid
590014619OtherRAIL ROAD MEDICARE
MD800296OtherDEPT OF LABOR
MD54199OtherAMERICAID
MD8317179OtherAETNA PPO
MDZ045ALOtherBCBS OF MD LOCAL PLAN
MD215435OtherMAMSI/ALLIANCE
MD263906OtherANTHEM/TRIGON BCBS OF VA
MD059878000Medicaid
MD800296OtherDEPT OF LABOR
MD54199OtherAMERICAID
MD590006059Medicare PIN
MDZ045Medicare PIN