Healthcare Provider Details

I. General information

NPI: 1528046653
Provider Name (Legal Business Name): LINCOLN BORO VFR CO AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 LIBERTY WAY
ELIZABETH PA
15037-3033
US

IV. Provider business mailing address

4312 LIBERTY WAY
ELIZABETH PA
15037-3033
US

V. Phone/Fax

Practice location:
  • Phone: 412-751-6080
  • Fax: 412-751-6080
Mailing address:
  • Phone: 412-751-6080
  • Fax: 412-751-6080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number02024
License Number StatePA

VIII. Authorized Official

Name: JAMES BEISLER
Title or Position: PRESIDENT
Credential:
Phone: 412-751-6080