1891781860 NPI number — KNOX AREA VOL AMBULANCE CO INC

Table of content: (NPI 1891781860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891781860 NPI number — KNOX AREA VOL AMBULANCE CO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOX AREA VOL AMBULANCE CO INC
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:
1891781860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2012
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:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
342 MAIN & RAILROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOX
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-797-1263
Provider Business Practice Location Address Fax Number:
814-797-1264
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SCHREFFLER
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
DIANNE
Authorized Official Title or Position:
CHIEF/ EMT-P
Authorized Official Telephone Number:
814-797-1263

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  03014 , 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: 306597 . This is a "UPMC HEALTH PLAN COMMERIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 441590609 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1495900 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 283523 . This is a "BCBS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P025688 . This is a "TRICARE NORTHEAST" identifier . This identifiers is of the category "OTHER".
  • Identifier: P025688 . This is a "UMWA HEALTH & RETIREMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007803870001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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