1043264211 NPI number — HARDING MT ZION AMBULANCE ASSOC

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 1043264211 NPI number — HARDING MT ZION AMBULANCE ASSOC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARDING MT ZION AMBULANCE ASSOC
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:
1043264211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 133
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALLS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18615-0133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-388-0983
Provider Business Mailing Address Fax Number:
570-388-4079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2035 ROUTE 92 HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARDING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18643-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-388-0983
Provider Business Practice Location Address Fax Number:
570-388-4079
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SAKALAS
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
570-388-0983

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: 297345 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0016844470001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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