Provider Demographics
NPI:1760584957
Name:COUNTY MEDICAL TRANSPORT, INC
Entity Type:Organization
Organization Name:COUNTY MEDICAL TRANSPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-582-6131
Mailing Address - Street 1:15852 FALLING WATERS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-2101
Mailing Address - Country:US
Mailing Address - Phone:301-582-6131
Mailing Address - Fax:301-223-7470
Practice Address - Street 1:15852 FALLING WATERS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-2101
Practice Address - Country:US
Practice Address - Phone:301-582-6131
Practice Address - Fax:301-223-7470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD54341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52248301OtherBC RENDERING PROV #
MD52248301OtherBC RENDERING PROV #