Provider Demographics
NPI:1902869092
Name:WELCOME AMBULANCE INC.
Entity Type:Organization
Organization Name:WELCOME AMBULANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATYSHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-820-0584
Mailing Address - Street 1:664 VALLEY STREAM CIR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1953
Mailing Address - Country:US
Mailing Address - Phone:215-750-0740
Mailing Address - Fax:215-750-0564
Practice Address - Street 1:1631 LORETTA AVE
Practice Address - Street 2:UNIT 3
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053-7310
Practice Address - Country:US
Practice Address - Phone:215-750-0740
Practice Address - Fax:215-750-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA030913416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000412000OtherINDEPENDENCE BLUE CROSS
PA30006053OtherKEYSTONE MERCY
PA0019487320001Medicaid
PA0000412000OtherINDEPENDENCE BLUE CROSS
PA069292Medicare ID - Type Unspecified