MEDICARE: BUSHKILL EMERGENCY CORPS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	02293	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0075873000	OTHER	PA	BLUE CROSS
3	441590859	OTHER	PA	PALMETO GBA

General Provider Information

NPI Number	:	1609944008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUSHKILL EMERGENCY CORPS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 417
Second Line	:
City	:	GILBERTSVILLE
State	:	PA
Zip	:	19525-0417
Country	:	US
Telephone Number	:	610-705-3979
Fax Number	:	610-705-3955

Provider Business Practice Location Address
First Line	:	3 STERLING COURT
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18302
Country	:	US
Telephone Number	:	570-223-1906
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. DEBBIE KULICK
Credential	:
Telephone Number	:	570-223-1906

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	10/16/2012

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