Healthcare Provider Details

I. General information

NPI: 1881643278
Provider Name (Legal Business Name): MACUNGIE AMBULANCE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 N WALNUT ST
MACUNGIE PA
18062-1323
US

IV. Provider business mailing address

5550 N WALNUT ST P.O.BOX 114
MACUNGIE PA
18062-1323
US

V. Phone/Fax

Practice location:
  • Phone: 610-966-2601
  • Fax: 610-966-1561
Mailing address:
  • Phone: 610-966-2601
  • Fax: 610-966-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number03289
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER GREB
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 610-966-2601