Provider Demographics
NPI:1831205848
Name:RHAWNHURST BUSTLETON AMBULANCE ASSOCIATION INC
Entity type:Organization
Organization Name:RHAWNHURST BUSTLETON AMBULANCE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIGMUND
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-698-9111
Mailing Address - Street 1:2044 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4355
Mailing Address - Country:US
Mailing Address - Phone:215-698-9111
Mailing Address - Fax:215-698-2918
Practice Address - Street 1:2044 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-4355
Practice Address - Country:US
Practice Address - Phone:215-698-9111
Practice Address - Fax:215-698-2918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040753416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA280528Medicare ID - Type Unspecified