Provider Demographics
NPI:1922053420
Name:ALTERNATIVE TRANSPORT LLC
Entity Type:Organization
Organization Name:ALTERNATIVE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:610-583-5064
Mailing Address - Street 1:660 13TH AVE
Mailing Address - Street 2:BLDG 1
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-1219
Mailing Address - Country:US
Mailing Address - Phone:610-583-5064
Mailing Address - Fax:610-583-5074
Practice Address - Street 1:660 13TH AVE
Practice Address - Street 2:BLDG 1
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076-1219
Practice Address - Country:US
Practice Address - Phone:610-583-5064
Practice Address - Fax:610-583-5074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA030793416L0300X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PW0000206000OtherINDEPEN BLUE CROSS PROV #
PA1110183OtherKEYSTONE MERCY PROV NMBR
PA33278OtherHEALTH PARTNERS PROV NUMB
PA1110183OtherKEYSTONE MERCY PROV NMBR
PA1110183OtherKEYSTONE MERCY PROV NMBR