Healthcare Provider Details

I. General information

NPI: 1841272770
Provider Name (Legal Business Name): HOLLIDAYSBURG AMERICAN LEGION HALA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SCOTCH VALLEY RD
HOLLIDAYSBURG PA
16648-9693
US

IV. Provider business mailing address

801 SCOTCH VALLEY RD PO BOX 461
HOLLIDAYSBURG PA
16648-9693
US

V. Phone/Fax

Practice location:
  • Phone: 814-695-1421
  • Fax: 814-695-8280
Mailing address:
  • Phone: 814-695-1421
  • Fax: 814-695-8280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number02235
License Number StatePA

VIII. Authorized Official

Name: GERALD T CORBIN
Title or Position: TREASURER BOARD OF DIRECTORS
Credential:
Phone: 814-695-1421