Provider Demographics
NPI:1881880029
Name:HORIZON AMBULANCE, INC
Entity type:Organization
Organization Name:HORIZON AMBULANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF BILLING DEPARTMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLASKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-676-5777
Mailing Address - Street 1:PO BOX 52485
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-7485
Mailing Address - Country:US
Mailing Address - Phone:215-676-5777
Mailing Address - Fax:215-676-5356
Practice Address - Street 1:124 S NORTH CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-7318
Practice Address - Country:US
Practice Address - Phone:215-676-5777
Practice Address - Fax:215-676-5356
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON AMBULANCE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083631Medicare PIN