Healthcare Provider Details

I. General information

NPI: 1497726400
Provider Name (Legal Business Name): SOUDERTON COMMUNITY AMBULANCE ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 WEST RELIANCE RD
TELFORD PA
18969
US

IV. Provider business mailing address

PO BOX 64214
SOUDERTON PA
18964-0214
US

V. Phone/Fax

Practice location:
  • Phone: 215-723-3400
  • Fax: 215-723-1552
Mailing address:
  • Phone: 215-723-3400
  • Fax: 215-723-1552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MS. SHIRLEY F FLICK
Title or Position: PRESIDENT
Credential: EMT
Phone: 215-723-3400