Provider Demographics
NPI:1912162827
Name:HOSPITAL AMBULANCE, LLC
Entity Type:Organization
Organization Name:HOSPITAL AMBULANCE, LLC
Other - Org Name:EAGLE MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-660-3153
Mailing Address - Street 1:11 QUAKERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08867-4135
Mailing Address - Country:US
Mailing Address - Phone:908-730-8000
Mailing Address - Fax:908-730-8005
Practice Address - Street 1:11 QUAKERTOWN RD
Practice Address - Street 2:
Practice Address - City:PITTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08867-4135
Practice Address - Country:US
Practice Address - Phone:908-730-8000
Practice Address - Fax:908-730-8005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHS INVESTMENT CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJEAG1001683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport