Healthcare Provider Details

I. General information

NPI: 1972709608
Provider Name (Legal Business Name): PALMYRA AMBULANCE ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W BROAD ST
PALMYRA NJ
08065-1626
US

IV. Provider business mailing address

PO BOX 18533
PITTSBURGH PA
15236-0533
US

V. Phone/Fax

Practice location:
  • Phone: 856-829-0500
  • Fax:
Mailing address:
  • Phone: 800-240-6365
  • Fax: 724-234-4703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberP0311033
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DANNY DAVID NORMAN JR.
Title or Position: CHIEF
Credential:
Phone: 856-296-6302