Provider Demographics
NPI:1144325762
Name:PA PARAMEDICS LLC
Entity type:Organization
Organization Name:PA PARAMEDICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:C
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:267-767-3807
Mailing Address - Street 1:1532 SOCIETY HILL DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-3689
Mailing Address - Country:US
Mailing Address - Phone:877-662-9911
Mailing Address - Fax:215-331-9912
Practice Address - Street 1:2731 HULMEVILLE RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4176
Practice Address - Country:US
Practice Address - Phone:877-662-9911
Practice Address - Fax:877-662-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA510343416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017818370001Medicaid
PA104527Medicare PIN