Healthcare Provider Details

I. General information

NPI: 1952111213
Provider Name (Legal Business Name): REVELATION RESPONSE EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 STATE ROUTE 168
GEORGETOWN PA
15043-1043
US

IV. Provider business mailing address

284 PITTSBURGH GRADE RD
HOOKSTOWN PA
15050-1326
US

V. Phone/Fax

Practice location:
  • Phone: 724-650-8232
  • Fax:
Mailing address:
  • Phone: 724-650-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL E HALLAM II
Title or Position: OWNER
Credential:
Phone: 724-650-8232