NPIMap

Organization Active NPI

Dynamic Ambulance, Inc.

  • Land Ambulance
  • Huntingdon Valley, PA
National Provider Identifier
1588897573
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
09019 Issued in PA
Legal business name
DYNAMIC AMBULANCE, INC.
Practice address
111 Buck Rd Ste 200
Huntingdon Valley, PA 19006-1552
Phone
(267) 307-9506
NPI assigned
Aug 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Luke Kinakh
Title
President
Phone
(215) 500-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 09019 PA Primary

Addresses

Primary practice location

111 Buck Rd Ste 200
Huntingdon Valley, PA 19006-1552

Mailing address

PO Box 662
Bryn Athyn, PA 19009-0662
Phone (215) 500-3070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091021000713 PA Part B Supplier - Ambulance Service Supplier 5193862266 Practice locations: Huntingdon Valley, PA

National Provider Directory

National Provider Directory

Locations

140 Tomlinson Rd
Unit 2000
Huntingdon Valley, PA 19006
Phone (215) 500-3070

140 Tomlinson Rd
Ste B
Huntingdon Vy, PA 19006
Phone (215) 500-3070

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525305600000",
    "number": "1588897573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662",
            "city": "BRYN ATHYN",
            "state": "PA",
            "postal_code": "190090662",
            "telephone_number": "215-500-3070",
            "fax_number": "215-689-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BUCK RD STE 200",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190061552",
            "telephone_number": "267-307-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2018-05-03",
        "status": "A",
        "authorized_official_last_name": "KINAKH",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-500-3070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "09019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.