Premium Care Medical Transport LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

13009 Issued in PA

Legal business name

PREMIUM CARE MEDICAL TRANSPORT LLC

Practice address

8600 W Chester Pike
Suite 306
Upper Darby, PA 19082-2629

Phone

(610) 446-1339

Fax

(215) 600-1228

NPI assigned

Jun 7, 2013

Organization subpart

No

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

Authorized official

Name

Samuel Charles

Title

Executive Director

Phone

(267) 227-9133

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1629416078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 W CHESTER PIKE",
            "address_2": "SUITE 306",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822629",
            "telephone_number": "610-446-1339",
            "fax_number": "215-600-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 W CHESTER PIKE",
            "address_2": "SUITE 306",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822629",
            "telephone_number": "610-446-1339",
            "fax_number": "215-600-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM CARE MEDICAL TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "267-227-9133"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "13009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.