Healthcare Provider Details

I. General information

NPI: 1194799759
Provider Name (Legal Business Name): BUFFALO TOWNSHIP EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 EKASTOWN RD
SARVER PA
16055-9524
US

IV. Provider business mailing address

PO BOX 30
SARVER PA
16055-0030
US

V. Phone/Fax

Practice location:
  • Phone: 724-353-2510
  • Fax: 724-353-2539
Mailing address:
  • Phone: 724-353-2510
  • Fax: 724-353-2539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number00172
License Number StatePA

VIII. Authorized Official

Name: ROXANNE SHAY
Title or Position: DIRECTOR
Credential:
Phone: 724-353-2510