Provider Demographics
NPI:1366868283
Name:ETA PRIORITY TRANSPORT INC.
Entity Type:Organization
Organization Name:ETA PRIORITY TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-648-9052
Mailing Address - Street 1:1931 POINT BREEZE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-2611
Mailing Address - Country:US
Mailing Address - Phone:267-648-9052
Mailing Address - Fax:215-543-3337
Practice Address - Street 1:1931 POINT BREEZE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2611
Practice Address - Country:US
Practice Address - Phone:267-648-9052
Practice Address - Fax:215-543-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-16
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAP.U.C A-6415264343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)