1306825765 NPI number — BEAR CREEK BUCK TOWNSHIP AMBULANCE ASSOCIATION

Table of content: (NPI 1306825765)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306825765 NPI number — BEAR CREEK BUCK TOWNSHIP AMBULANCE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEAR CREEK BUCK TOWNSHIP 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:
1306825765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-0207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-664-2007
Provider Business Mailing Address Fax Number:
484-664-2015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3335 BEAR CREEK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAR CREEK TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702-9760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-825-7111
Provider Business Practice Location Address Fax Number:
570-825-7111
Provider Enumeration Date:
01/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCGOWAN
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
570-825-7111

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  40047 , 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: 0014856030003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080161 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200371 . This is a "BC BS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 232402644 . This is a "BC OF NE PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 232402644 . This is a "PA TURNPIKE COMMISION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 833809 . This is a "UMWA HEALTH RETIREMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0021908 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590011745 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 232402644 . This is a "HEALTHMATE HMO DPA" identifier . This identifiers is of the category "OTHER".




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