Provider Demographics
NPI:1669446274
Name:MOBILE NURSE NETWORK, LLC
Entity Type:Organization
Organization Name:MOBILE NURSE NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-620-2848
Mailing Address - Street 1:205 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-1984
Mailing Address - Country:US
Mailing Address - Phone:724-620-2848
Mailing Address - Fax:724-620-2951
Practice Address - Street 1:205 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1984
Practice Address - Country:US
Practice Address - Phone:724-620-2848
Practice Address - Fax:724-620-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA050253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1736072OtherBLUE CROSS/BLUE SHIELD
PA089792Medicare ID - Type Unspecified