Provider Demographics
NPI:1124320221
Name:PENN HEALTH AMBULANCE CORP
Entity type:Organization
Organization Name:PENN HEALTH AMBULANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUGHTAI
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:267-770-8488
Mailing Address - Street 1:111 BUCK RD UNIT 300
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1544
Mailing Address - Country:US
Mailing Address - Phone:267-770-8488
Mailing Address - Fax:
Practice Address - Street 1:111 BUCK RD UNIT 300
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1544
Practice Address - Country:US
Practice Address - Phone:267-770-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10041341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance