1841299872 NPI number — MONT ALTO AMBULANCE ASSOCIATION

Table of content: (NPI 1841299872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841299872 NPI number — MONT ALTO AMBULANCE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONT ALTO 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:
1841299872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONT ALTO
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17237-0327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-749-5558
Provider Business Mailing Address Fax Number:
717-749-5999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
603 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONT ALTO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17237-0327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-749-5558
Provider Business Practice Location Address Fax Number:
717-749-5999
Provider Enumeration Date:
07/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-749-5552

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: 68743 . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 36403 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0035984000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 280197 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 39EA32 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 95794 . This is a "HEALTH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0035984000 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 407517000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 832915182A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0016719680001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2462831 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com