Provider Demographics
NPI:1396570909
Name:MERCY MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:MERCY MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:917-564-4567
Mailing Address - Street 1:4000 PRESIDENTIAL BLVD APT 517
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1717
Mailing Address - Country:US
Mailing Address - Phone:917-564-4567
Mailing Address - Fax:
Practice Address - Street 1:535 ROUTE 38 STE 355F
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2976
Practice Address - Country:US
Practice Address - Phone:917-564-4567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)