Healthcare Provider Details

I. General information

NPI: 1891781860
Provider Name (Legal Business Name): KNOX AREA VOL AMBULANCE CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 MAIN & RAILROAD
KNOX PA
16232
US

IV. Provider business mailing address

PO BOX 207
ALLENTOWN PA
18105-0207
US

V. Phone/Fax

Practice location:
  • Phone: 814-797-1263
  • Fax: 814-797-1264
Mailing address:
  • Phone: 484-664-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03014
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier306597
Identifier TypeOTHER
Identifier State
Identifier IssuerUPMC HEALTH PLAN COMMERIC
# 2
Identifier441590609
Identifier TypeOTHER
Identifier State
Identifier IssuerUNITED HC RR MEDICARE
# 3
Identifier1495900
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA USHC BLUE BELL HMO
# 4
Identifier283523
Identifier TypeOTHER
Identifier State
Identifier IssuerBCBS OF PA BLUE SHIELD
# 5
IdentifierP025688
Identifier TypeOTHER
Identifier State
Identifier IssuerTRICARE NORTHEAST
# 6
IdentifierP025688
Identifier TypeOTHER
Identifier State
Identifier IssuerUMWA HEALTH & RETIREMENT
# 7
Identifier0007803870001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: DONNA DIANNE SCHREFFLER
Title or Position: CHIEF/ EMT-P
Credential:
Phone: 814-797-1263