Provider Demographics
NPI:1659436020
Name:UNITED MEDICAL TRANSPORT, LTD.
Entity Type:Organization
Organization Name:UNITED MEDICAL TRANSPORT, LTD.
Other - Org Name:UNITED MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDYUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-969-7700
Mailing Address - Street 1:PO BOX 21028
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-0528
Mailing Address - Country:US
Mailing Address - Phone:215-969-7700
Mailing Address - Fax:215-969-7006
Practice Address - Street 1:2860 HEDLEY ST
Practice Address - Street 2:SUITE # 103
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19137-1919
Practice Address - Country:US
Practice Address - Phone:215-969-7700
Practice Address - Fax:215-969-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040393416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080024Medicare ID - Type UnspecifiedMEDICARE