Healthcare Provider Details

I. General information

NPI: 1043264211
Provider Name (Legal Business Name): HARDING MT ZION AMBULANCE ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 ROUTE 92 HWY
HARDING PA
18643-3100
US

IV. Provider business mailing address

PO BOX 133
FALLS PA
18615-0133
US

V. Phone/Fax

Practice location:
  • Phone: 570-388-0983
  • Fax: 570-388-4079
Mailing address:
  • Phone: 570-388-0983
  • Fax: 570-388-4079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier297345
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE SHIELD
# 2
Identifier0016844470001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: LORI SAKALAS
Title or Position: TREASURER
Credential:
Phone: 570-388-0983