1235138108 NPI number — NUREMBERG COMMUNITY AMBULANCE ASSOCIATION

Table of content: (NPI 1235138108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235138108 NPI number — NUREMBERG COMMUNITY AMBULANCE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NUREMBERG COMMUNITY AMBULANCE ASSOCIATION
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:
1235138108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 726
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CUMBERLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17070-0726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-214-6018
Provider Business Mailing Address Fax Number:
717-214-6020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HAZLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NUREMBERG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-384-3405
Provider Business Practice Location Address Fax Number:
570-384-3266
Provider Enumeration Date:
07/21/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DEMSHOCK
Authorized Official First Name:
DAVE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
570-384-3405

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  04023 , 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)