Healthcare Provider Details

I. General information

NPI: 1275755522
Provider Name (Legal Business Name): PERRYOPOLIS AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 INDEPENDENCE
PERRYOPOLIS PA
15473
US

IV. Provider business mailing address

321 INDEPENDENCE
PERRYOPOLIS PA
15473
US

V. Phone/Fax

Practice location:
  • Phone: 724-736-8124
  • Fax:
Mailing address:
  • Phone: 724-736-8124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number26020
License Number StatePA

VIII. Authorized Official

Name: MRS. KAREN DEANGELIS
Title or Position: OFFICE MANAGER
Credential:
Phone: 724-736-8124