Provider Demographics
NPI:1588819007
Name:FRIENDSHIP AMBULANCE SERVICE TRANSPORT
Entity Type:Organization
Organization Name:FRIENDSHIP AMBULANCE SERVICE TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MISCHICO
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-494-2484
Mailing Address - Street 1:1628 HUDDELL AVE
Mailing Address - Street 2:
Mailing Address - City:BOOTHWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4223
Mailing Address - Country:US
Mailing Address - Phone:610-494-2484
Mailing Address - Fax:
Practice Address - Street 1:1628 HUDDELL AVE
Practice Address - Street 2:
Practice Address - City:BOOTHWYN
Practice Address - State:PA
Practice Address - Zip Code:19061-4223
Practice Address - Country:US
Practice Address - Phone:610-494-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport