Provider Demographics
NPI:1801862958
Name:PLUM EMERGENCY MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:PLUM EMERGENCY MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:IZYDORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-793-4801
Mailing Address - Street 1:4545 NEW TEXAS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-1136
Mailing Address - Country:US
Mailing Address - Phone:412-793-4801
Mailing Address - Fax:412-793-4837
Practice Address - Street 1:4545 NEW TEXAS RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-1136
Practice Address - Country:US
Practice Address - Phone:412-793-4801
Practice Address - Fax:412-793-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA051513416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012354400002Medicaid
PA590006402OtherRAILROAD MEDICARE
PA590006402OtherRAILROAD MEDICARE