Provider Demographics
NPI:1497867113
Name:EMINENT MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:EMINENT MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-478-0001
Mailing Address - Street 1:P.O. BOX 376
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5419
Mailing Address - Country:US
Mailing Address - Phone:484-478-0001
Mailing Address - Fax:
Practice Address - Street 1:61 S MORTON AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1740
Practice Address - Country:US
Practice Address - Phone:484-478-0001
Practice Address - Fax:484-478-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA06139341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017713850001Medicaid
PAP00370796OtherRAILROAD MEDICARE
PAP00370796OtherRAILROAD MEDICARE