1033190228 NPI number — TRANS-MED AMBULANCE INC.

Table of content: (NPI 1033190228)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033190228 NPI number — TRANS-MED AMBULANCE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANS-MED AMBULANCE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033190228
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 MARION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUZERNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18709-1419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-283-2444
Provider Business Mailing Address Fax Number:
570-287-3384

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 MARION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUZERNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18709-1419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-283-2444
Provider Business Practice Location Address Fax Number:
570-287-3384
Provider Enumeration Date:
11/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BERLEW
Authorized Official First Name:
HOMER
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
570-283-2444

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  04250 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0978405 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20046443 . This is a "AMERI HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 998503 . This is a "CAPTIAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 205186 . This is a "FEDERAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 998503 . This is a "BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00155849 . This is a "MEDICARE TRAVELERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0459812 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1011364360001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 611668600 . This is a "BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 998503 . This is a "BLUE CROSS/BLUE SHIELD NE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 818408 . This is a "FIRST PRIORITY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1011364360002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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