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Cetronia Ambulance Corps Inc
4300 Broadway
Allentown, PA 18104
Phone:
(844) 352 - 9402
Fax:
(484) 664 - 2015
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Error Summary
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1. Patient Information
First Name
*
M.I.
Last Name
*
Patient Account Number
*
YOUR PATIENT ACCOUNT NUMBER IS HIGHLIGHTED IN YELLOW AT THE TOP OF YOUR TRANSPORT INVOICE
Patient Name
*
Email Address
A receipt will be sent to this email address.
2. Payment Amount
Amount
THIS PAYMENT IS BEING MADE FOR THE TRANSPORT OF A PATIENT BY CETRONIA AMBULANCE CORPS
3. Payment Method
Credit/Debit Card
Bank Account
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*
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