Healthcare Provider Details

I. General information

NPI: 1992795025
Provider Name (Legal Business Name): PICTURE ROCKS VOL FIRE CO AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 12/12/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 NORTH MAIN ST
PICTURE ROCKS PA
17762-9998
US

IV. Provider business mailing address

409 PORTER AVE
SCOTTDALE PA
15683-1141
US

V. Phone/Fax

Practice location:
  • Phone: 570-584-4115
  • Fax: 570-584-2492
Mailing address:
  • Phone: 724-887-6822
  • Fax: 724-887-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number03342
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: LINDA A HOPKINS
Title or Position: SECRETARY
Credential:
Phone: 570-584-4115