Provider Demographics
NPI:1447549423
Name:MEDICAL ESSCORT, INC.
Entity type:Organization
Organization Name:MEDICAL ESSCORT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZURAB
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBASHIDZE
Authorized Official - Suffix:
Authorized Official - Credentials:FIRST RESPONDER
Authorized Official - Phone:215-677-2000
Mailing Address - Street 1:220 GEIGER RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1030
Mailing Address - Country:US
Mailing Address - Phone:215-677-2000
Mailing Address - Fax:215-677-2000
Practice Address - Street 1:220 GEIGER RD
Practice Address - Street 2:SUITE 204
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1030
Practice Address - Country:US
Practice Address - Phone:215-677-2000
Practice Address - Fax:215-677-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11013341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance