Healthcare Provider Details

I. General information

NPI: 1194707992
Provider Name (Legal Business Name): RIDGWAY AMBULANCE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N BROAD ST
RIDGWAY PA
15853-2103
US

IV. Provider business mailing address

301 N BROAD ST
RIDGWAY PA
15853-2103
US

V. Phone/Fax

Practice location:
  • Phone: 814-773-3633
  • Fax: 814-772-1001
Mailing address:
  • Phone: 814-773-3633
  • Fax: 814-772-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number03347
License Number StatePA

VIII. Authorized Official

Name: MR. ROBERT LOUIS MARNATTI
Title or Position: MANAGER
Credential: NREMT-PARAMEDIC
Phone: 814-773-3633