Provider Demographics
NPI:1710085485
Name:SOUTHERN CHESTER EMS
Entity Type:Organization
Organization Name:SOUTHERN CHESTER EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTCHKISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-869-1327
Mailing Address - Street 1:33 OMEGA DRIVE BLDG J
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:800-697-5147
Mailing Address - Fax:302-456-5725
Practice Address - Street 1:1015 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9459
Practice Address - Country:US
Practice Address - Phone:610-869-1339
Practice Address - Fax:610-869-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03236341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1232921Medicaid
PA1232921Medicaid