Provider Demographics
NPI:1588897573
Name:DYNAMIC AMBULANCE, INC.
Entity type:Organization
Organization Name:DYNAMIC AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINAKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-500-3070
Mailing Address - Street 1:PO BOX 662
Mailing Address - Street 2:
Mailing Address - City:BRYN ATHYN
Mailing Address - State:PA
Mailing Address - Zip Code:19009-0662
Mailing Address - Country:US
Mailing Address - Phone:215-500-3070
Mailing Address - Fax:215-689-0808
Practice Address - Street 1:111 BUCK RD STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1552
Practice Address - Country:US
Practice Address - Phone:267-307-9506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA090193416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport