Healthcare Provider Details

I. General information

NPI: 1992797765
Provider Name (Legal Business Name): WARWICK COMMUNITY AMBULANCE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 NORTH LN
LITITZ PA
17543-1505
US

IV. Provider business mailing address

PO BOX 42
LITITZ PA
17543-0042
US

V. Phone/Fax

Practice location:
  • Phone: 717-626-1200
  • Fax: 717-627-0728
Mailing address:
  • Phone: 717-626-1200
  • Fax: 717-627-0728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number05189
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier000746554
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: FRANK KENAVAN
Title or Position: CFO
Credential:
Phone: 717-626-1200