Provider Demographics
NPI:1811972722
Name:PRO-TECH AMBULANCE COMPANY, INC.
Entity type:Organization
Organization Name:PRO-TECH AMBULANCE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:215-427-9001
Mailing Address - Street 1:3325 EDGEMONT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-5305
Mailing Address - Country:US
Mailing Address - Phone:215-427-9001
Mailing Address - Fax:215-427-9009
Practice Address - Street 1:3325 EDGEMONT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-5305
Practice Address - Country:US
Practice Address - Phone:215-427-9001
Practice Address - Fax:215-427-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03064341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA234577Medicare ID - Type UnspecifiedPENNSYLVANIA MEDICARE