Healthcare Provider Details

I. General information

NPI: 1811996283
Provider Name (Legal Business Name): THE MONTROSE MINUTE MEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 HOLLISTER DR.
MONTROSE PA
18801
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 570-278-9188
  • Fax: 570-888-1219
Mailing address:
  • Phone: 315-635-1789
  • Fax: 315-635-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03335
License Number StatePA

VIII. Authorized Official

Name: VINCENT BIRCHARD
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 570-278-9188