Provider Demographics
NPI:1942287297
Name:ALLIED MEDICAL AMBULANCE INC
Entity Type:Organization
Organization Name:ALLIED MEDICAL AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEREZ
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-664-4775
Mailing Address - Street 1:168 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1311
Mailing Address - Country:US
Mailing Address - Phone:610-664-4775
Mailing Address - Fax:610-664-5794
Practice Address - Street 1:168 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1311
Practice Address - Country:US
Practice Address - Phone:610-664-4775
Practice Address - Fax:610-664-5794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA13-00683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007319090001Medicaid
PA286356Medicare ID - Type UnspecifiedPROVIDER