Pro Medic Ambulance, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

11047 Issued in PA

Legal business name

PRO MEDIC AMBULANCE, INC

Practice address

207 Buck Rd
Unit 4
Holland, PA 18966-1700

Phone

(267) 262-0068

NPI assigned

Oct 12, 2011

Last updated

Jun 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Volodymir Gregory Matkivski

Title

Manager

Phone

(267) 262-0068

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1659656445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 BUCK RD",
            "address_2": "UNIT 4",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 BUCK RD",
            "address_2": "UNIT 4",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661700",
            "telephone_number": "267-262-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MEDIC AMBULANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "MATKIVSKI",
        "authorized_official_first_name": "VOLODYMIR",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "267-262-0068",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "11047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102658319",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Holland, PA
• Providers in Holland, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.