1861480949 NPI number — PLAINS VOLUNTEER AMBULANCE ASSOCIATION

Table of content: (NPI 1861480949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861480949 NPI number — PLAINS VOLUNTEER AMBULANCE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLAINS VOLUNTEER AMBULANCE ASSOCIATION
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:
1861480949
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2011
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:
90 MAFFETT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-822-9279
Provider Business Practice Location Address Fax Number:
570-223-6226
Provider Enumeration Date:
10/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ZABRISKI
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
570-822-9279

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  03366 , 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: 590004230 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA3384 . This is a "PHS HEALTH PLAN COMMERCIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 118002600 . This is a "DEPT OF LABOR WORK COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0603710 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 51687 . This is a "GHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1063900 . This is a "KEYSTONE MERCY HMO DPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0012187710002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 089529300 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 801060 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 895293 . This is a "UMWA HEALTH AND RET FUNDS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201642 . This is a "BCBS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA3384 . This is a "ACS HEALTH NET HMO MDC" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA3384 . This is a "QUALMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA3384 . This is a "ACS HEALTH NET COMMERCIAL" identifier . This identifiers is of the category "OTHER".




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