1316910730 NPI number — TRAFFORD EMERGENCY MEDICAL SERVICE COMPANY NO 1

Table of content: (NPI 1316910730)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316910730 NPI number — TRAFFORD EMERGENCY MEDICAL SERVICE COMPANY NO 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRAFFORD EMERGENCY MEDICAL SERVICE COMPANY NO 1
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:
TRAFFORD EMS
Provider Other Organization Name Type Code:
3
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:
1316910730
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
892 NEW CASTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SLIPPERY ROCK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16057-4228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-280-5974
Provider Business Mailing Address Fax Number:
724-794-1633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
412 BRINTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRAFFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15085-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-856-2286
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LINDBLOOM
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
MARK
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
412-491-1153

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  65032 , 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: 0182373 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209214 . This is a "UPMC HEALTH PLAN COMMERCI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 204619 . This is a "BC BS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0015027500004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590009448 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1538717 . This is a "UMWA HEALTH AND RETIREMEN" identifier . This identifiers is of the category "OTHER".




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