1295736197 NPI number — BUTLER AMBULANCE SERVICE CO

Table of content: (NPI 1295736197)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295736197 NPI number — BUTLER AMBULANCE SERVICE CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUTLER AMBULANCE SERVICE CO
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:
1295736197
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUTLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16001-4719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-282-9595
Provider Business Mailing Address Fax Number:
724-285-8363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUTLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16001-4719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-282-9595
Provider Business Practice Location Address Fax Number:
724-285-8363
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BACHER
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-282-9595

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  03045 , 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: 0007036370001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119743500 . This is a "DEPARTMENT OF LABOR ACS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0088668 . This is a "UMULA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 80485 . This is a "US HEALTHCARE AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P019290 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 285838 . This is a "BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5901305-80 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080121800 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1013548 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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