MEDICARE: DUBOIS EMERGENCY MEDICAL SERVICES AMBULANCE

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1342045	OTHER	PA	UNITED MINE WORKERS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669463931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUBOIS EMERGENCY MEDICAL SERVICES AMBULANCE

Provider Business Mailing Address
First Line	:	PO BOX 333
Second Line	:
City	:	DU BOIS
State	:	PA
Zip	:	15801-0333
Country	:	US
Telephone Number	:	814-375-1185
Fax Number	:	814-375-4303

Provider Business Practice Location Address
First Line	:	103 W WASHINGTON AVE
Second Line	:
City	:	DU BOIS
State	:	PA
Zip	:	15801-2006
Country	:	US
Telephone Number	:	814-375-1185
Fax Number	:	814-375-4303

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. PATRICK J WILLAR
Credential	:
Telephone Number	:	814-375-1185

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	05/29/2008

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Directions to “DUBOIS EMERGENCY MEDICAL SERVICES AMBULANCE ” Practice Location

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