Provider Demographics
NPI:1043518582
Name:MONTGOMERY COUNTY MH/MR EMERGENCY SERVICE, INC.
Entity type:Organization
Organization Name:MONTGOMERY COUNTY MH/MR EMERGENCY SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:610-279-6100
Mailing Address - Street 1:50 BEECH DR
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5421
Mailing Address - Country:US
Mailing Address - Phone:610-279-6100
Mailing Address - Fax:610-279-0978
Practice Address - Street 1:50 BEECH DR
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-5421
Practice Address - Country:US
Practice Address - Phone:610-279-6100
Practice Address - Fax:610-279-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03261341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007568020007Medicaid