Organization
GENESIS MEDICAL TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREY PRIKHODKO (PRESIDENT)
(610) 333-3401
Entity
Organization
Contact information
Practice address
2180 MARGARET ST, PHILADELPHIA, PA 19124-2839
(610) 333-3401
Mailing address
1739 BLEIGH AVE, PHILADELPHIA, PA 19111-3829
(267) 934-1335
(215) 525-6122
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
11051
PA
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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