1528054699 NPI number — HANOVER TOWNSHIP COMMUNITY AMBULANCE ASSOCIATION INC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528054699 NPI number — HANOVER TOWNSHIP COMMUNITY AMBULANCE ASSOCIATION INC

Employer Identification Number (EIN):

Provider Organization Name:

HANOVER TOWNSHIP COMMUNITY AMBULANCE ASSOCIATION INC

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

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Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

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Provider Other Name Prefix Text:

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Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1528054699

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

11/01/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

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:

800-473-2278

Provider Business Mailing Address Fax Number:

484-664-2015

Provider First Line Business Practice Location Address:

1001 CENTER ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

HANOVER TOWNSHIP

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

18706-5034

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

570-825-1266

Provider Business Practice Location Address Fax Number:

570-970-9830

Provider Enumeration Date:

09/23/2005

Authorized Official Last Name:

RINKEVICH

Authorized Official First Name:

FRANK

Authorized Official Middle Name:

D

Authorized Official Title or Position:

FINANCIAL SEC

Authorized Official Telephone Number:

570-822-4213

• Taxonomy code: 3416L0300X , with the licence number:  04188 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 208815 . This is a "BC BS OF PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: PA0497 . This is a "QUALMED" identifier . This identifiers is of the category "OTHER".
• Identifier: 0585780 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 811093 . This is a "UMWA HEALTH & RETIREMENT" identifier . This identifiers is of the category "OTHER".
• Identifier: P032492 . This is a "TRI CARE MID ATL" identifier . This identifiers is of the category "OTHER".
• Identifier: PA0497 . This is a "ACS HEALTH NET HMO MDC" identifier . This identifiers is of the category "OTHER".
• Identifier: 0014373480003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: P032492 . This is a "TRI CARE NORTHEAST" identifier . This identifiers is of the category "OTHER".
• Identifier: PA0497 . This is a "PHS HEALTH PLAN HMO MDC" identifier . This identifiers is of the category "OTHER".
• Identifier: 081109300 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
• Identifier: PA0497 . This is a "ACS HEALTH NET COMMERCIAL" identifier . This identifiers is of the category "OTHER".
• Identifier: 077535 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: PA0497 . This is a "PHS HEALTH PLAN COMMERCIA" identifier . This identifiers is of the category "OTHER".