Organization
MIDATLANTIC MEDEVAC LLC
Active
Other names
MidAtlantic MedEvac
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAL SPATZ (DIRECTOR)
(215) 762-4713
Entity
Organization
Contact information
Practice address
230 NORTH BROAD STREET, SUITE 487, PHILADELPHIA, PA 19102-1192
(215) 762-4713
(215) 762-1803
Mailing address
PO BOX 822356, PHILADELPHIA, PA 19182
(215) 762-4713
(215) 762-1803
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
02134
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0254302000
KEYSTONE HEALTH PLAN EAST
PA
01
—
1011339
AMERIHEALTH
PA
01
—
1126864
HORIZON NJ HEALTH
PA
01
—
1268051
AETNA
PA
01
—
20051037
AMERIHEALTH MERCY
PA
01
—
30032593
KEYSTONE MERCY HEALTH PLA
PA
01
—
91002039100
AMERICHOICE
PA
Enumeration date
03/12/2007
Last updated
09/26/2008
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