Healthcare Provider Details

I. General information

NPI: 1962455238
Provider Name (Legal Business Name): LAWRENCEVILLE FIREMENS AMBULANCE ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9-11 MECHANIC ST.
LAWRENCEVILLE PA
16929-9768
US

IV. Provider business mailing address

PO BOX 177
LAWRENCEVILLE PA
16929-0177
US

V. Phone/Fax

Practice location:
  • Phone: 570-827-2047
  • Fax: 570-827-2010
Mailing address:
  • Phone: 570-827-2047
  • Fax: 570-827-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WENDY L SIX
Title or Position: TREASURER
Credential:
Phone: 570-827-2047