Provider Demographics
NPI:1790030468
Name:FAMILY CARE TRANSPORT, INC
Entity Type:Organization
Organization Name:FAMILY CARE TRANSPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESFIR
Authorized Official - Middle Name:
Authorized Official - Last Name:POLISHCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-913-3474
Mailing Address - Street 1:433 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:433 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3631
Practice Address - Country:US
Practice Address - Phone:215-913-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport