Provider Demographics
NPI:1861782948
Name:MOBILE CARE TRANSPORT
Entity type:Organization
Organization Name:MOBILE CARE TRANSPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-425-1900
Mailing Address - Street 1:PO BOX 3668
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-0668
Mailing Address - Country:US
Mailing Address - Phone:215-425-1900
Mailing Address - Fax:215-425-2900
Practice Address - Street 1:1918 E WESTMORELAND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2522
Practice Address - Country:US
Practice Address - Phone:215-425-1900
Practice Address - Fax:215-425-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA230140Medicare PIN