Provider Demographics
NPI:1780638924
Name:JATMON ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JATMON ENTERPRISES, INC.
Other - Org Name:ACE EMERGENCY MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-624-9099
Mailing Address - Street 1:PO BOX 660
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-0660
Mailing Address - Country:US
Mailing Address - Phone:717-624-9099
Mailing Address - Fax:717-624-7953
Practice Address - Street 1:4940 YORK RD
Practice Address - Street 2:
Practice Address - City:NEW OXFORD
Practice Address - State:PA
Practice Address - Zip Code:17350-9401
Practice Address - Country:US
Practice Address - Phone:717-624-9099
Practice Address - Fax:717-624-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1884781OtherHIGHMARK BLUE SHIELD
MD414009500Medicaid
PA000000198969OtherUNISON HEALTH PLAN
PA1016390880001Medicaid
PA50062517OtherCAPITAL BLUE CROSS
PA1884781OtherHIGHMARK BLUE SHIELD
PA100469Medicare PIN