Provider Demographics
NPI:1013159078
Name:CARDIAC CARE AMBULANCE, INC.
Entity Type:Organization
Organization Name:CARDIAC CARE AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TKACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-282-5252
Mailing Address - Street 1:549 FOUNDRY RD
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3901
Mailing Address - Country:US
Mailing Address - Phone:267-282-5252
Mailing Address - Fax:
Practice Address - Street 1:549 FOUNDRY RD
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3901
Practice Address - Country:US
Practice Address - Phone:267-282-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJC22120243416L0300X
PA090093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport