Provider Demographics
NPI:1356524714
Name:HEALTHATLANTIC LLC
Entity type:Organization
Organization Name:HEALTHATLANTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXEC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLET
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:800-789-0912
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-0074
Mailing Address - Country:US
Mailing Address - Phone:800-789-0912
Mailing Address - Fax:610-927-6339
Practice Address - Street 1:200 BULLTOWN RD
Practice Address - Street 2:
Practice Address - City:ELVERSON
Practice Address - State:PA
Practice Address - Zip Code:19520
Practice Address - Country:US
Practice Address - Phone:800-789-0912
Practice Address - Fax:610-927-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-08
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA070013416L0300X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1569126OtherGATEWAY
PA20080255OtherAMERIHEALTH MERCY
PA1020857160002Medicaid
PA30049520OtherKEYSTONE MERCY
PA3504884000OtherKEYSTONE 65
PA002022122OtherHIGHMARK BXBS
PA1569126OtherGATEWAY
PA1020857160002Medicaid