Healthcare Provider Details

I. General information

NPI: 1205826476
Provider Name (Legal Business Name): L-J-L TRUCKING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 PHILADELPHIA AVE
NORTHERN CAMBRIA PA
15714
US

IV. Provider business mailing address

1311 PHILADELPHIA AVE
NORTHERN CAMBRIA PA
15714-1181
US

V. Phone/Fax

Practice location:
  • Phone: 814-948-6170
  • Fax: 814-948-6184
Mailing address:
  • Phone: 814-948-6170
  • Fax: 814-948-6184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number11203
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberA-00112962
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number11203
License Number StatePA

VIII. Authorized Official

Name: LIN S YACHTIS
Title or Position: VICE PRESIDENT
Credential:
Phone: 814-948-6170