1033283726 NPI number — THOMPSONTOWN AMBULANCE LEAGUE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033283726 NPI number — THOMPSONTOWN AMBULANCE LEAGUE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMPSONTOWN AMBULANCE LEAGUE
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:
1033283726
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2013
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:
3 CEDAR COURT
Provider Business Mailing Address City Name:
ENOLA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17025-0098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-728-9223
Provider Business Mailing Address Fax Number:
717-728-9344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STATE AND TANNER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THOMPSONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-535-4519
Provider Business Practice Location Address Fax Number:
717-535-4518
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOWER
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
SUZANNE
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
717-436-9535

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0010815220005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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