1205812823 NPI number — COMMUNITY AMBULANCE ASSOCIATION OF AMBLER

Table of content: (NPI 1205812823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205812823 NPI number — COMMUNITY AMBULANCE ASSOCIATION OF AMBLER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY AMBULANCE ASSOCIATION OF AMBLER
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:
1205812823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 98
Provider Second Line Business Mailing Address:
1414 E BUTLER PIKE
Provider Business Mailing Address City Name:
AMBLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-643-6517
Provider Business Mailing Address Fax Number:
215-643-5212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 E BUTLER PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMBLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19002-3764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-643-6517
Provider Business Practice Location Address Fax Number:
215-643-5212
Provider Enumeration Date:
12/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ENGLE
Authorized Official First Name:
DOROTHY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
BILLING SERVICES
Authorized Official Telephone Number:
215-643-6517

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  03146 , 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: 0007173830003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com