1912995747 NPI number — MOUNTAINTP COMMUNITY AMBULANCE

Table of content: (NPI 1912995747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912995747 NPI number — MOUNTAINTP COMMUNITY AMBULANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNTAINTP COMMUNITY AMBULANCE
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:
6
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:
1912995747
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2010
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:
RTE 437-309
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTAIN TOP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-474-2513
Provider Business Practice Location Address Fax Number:
570-474-2513
Provider Enumeration Date:
10/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HERRON
Authorized Official First Name:
JEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER/DIRECTOR
Authorized Official Telephone Number:
570-474-9751

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0X00PA0847 . This is a "QUALMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0597142 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0X00PA0847 . This is a "ACS HEALTHNET HMO MDC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0X00PA0847 . This is a "PHS HEALTH PLAN COMMERCIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0014802690003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0X00PA0847 . This is a "PHS HEALTH PLAN HMO MDC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590008832 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0X00PA0847 . This is a "ACS HEALTHNET COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1587077 . This is a "BCBS OF NE PA ACESS CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 225955 . This is a "BC BS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 077070 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com