Healthcare Provider Details

I. General information

NPI: 1255436150
Provider Name (Legal Business Name): TRI-COMMUNITY AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 CHESS ST
MONONGAHELA PA
15063-2447
US

IV. Provider business mailing address

PO BOX 93
MONONGAHELA PA
15063-0093
US

V. Phone/Fax

Practice location:
  • Phone: 724-258-7789
  • Fax: 724-258-4991
Mailing address:
  • Phone: 724-258-0841
  • Fax: 724-258-4991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03216
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier0008486340002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: RAMONA M. BRIGHT IX
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 724-258-0841