Healthcare Provider Details

I. General information

NPI: 1437149564
Provider Name (Legal Business Name): ROSTRAVER WEST NEWTON EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PLEASANT VALLEY BLVD
BELLE VERNON PA
15012-4002
US

IV. Provider business mailing address

PO BOX 603
BELLE VERNON PA
15012-0603
US

V. Phone/Fax

Practice location:
  • Phone: 724-929-9116
  • Fax: 724-929-3159
Mailing address:
  • Phone: 724-929-9116
  • Fax: 724-929-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number04162
License Number StatePA

VIII. Authorized Official

Name: MR. GREG COMINSKY
Title or Position: OFFICE MANAGER
Credential:
Phone: 724-929-9116