Organization
PROFESSIONAL MEDICAL TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE MOSKO RN (CEO)
(215) 651-4052
Entity
Organization
Contact information
Practice address
513 11TH AVE, HADDON HEIGHTS, NJ 08035-1803
(215) 651-4052
Mailing address
513 11TH AVE, HADDON HEIGHTS, NJ 08035-1803
(215) 651-4052
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400157680
CORPORATION NUMBER
NJ
Enumeration date
02/21/2007
Last updated
08/22/2020
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