1861488934 NPI number — HAMBURG EMERGENCY MEDICAL SERVICES, INC.

Table of content: (NPI 1861488934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861488934 NPI number — HAMBURG EMERGENCY MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMBURG EMERGENCY MEDICAL SERVICES, INC.
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:
1861488934
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 24
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELVERSON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19520-0024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-286-5076
Provider Business Mailing Address Fax Number:
610-286-5079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
564 FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19526-1116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-562-5562
Provider Business Practice Location Address Fax Number:
610-562-7543
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KIEFFER
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
484-818-1732

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  03398 , 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: 0016144060001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30013907 . This is a "KEYSTONE MERCY HMO DPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50002980 . This is a "CAPITAL BLUE CROSS BASIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1015359 . This is a "AMERIHEALTH MERCY HMO DPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 280260 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0005874 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".




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