Organization
SOVEREIGN MEDICAL RESPONSE AMBULANCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ILYA GUBA EMR (PRESIDENT)
(215) 444-0295
Entity
Organization
Contact information
Practice address
780 FALCON CIR, SUITE 127, WARMINSTER, PA 18974-5130
(215) 444-0295
(215) 444-0296
Mailing address
780 FALCON CIR, SUITE 127, WARMINSTER, PA 18974-5130
(215) 444-0295
(215) 444-0296
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
12034
PA
341600000X
Ambulance
Primary
14016
PA
Other
Enumeration date
07/06/2012
Last updated
11/24/2014
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