Healthcare Provider Details
I. General information
NPI: 1265566913
Provider Name (Legal Business Name): WESTERN ALLIANCE EMERGENCY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2007
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
430 CANTON ST
TROY PA
16947-1444
US
IV. Provider business mailing address
PO BOX 13
TROY PA
16947-0013
US
V. Phone/Fax
- Phone: 570-297-1235
- Fax:
- Phone: 570-297-1235
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
CARMAN
Title or Position: EXECUTIVE DIRECTOR-CEO
Credential:
Phone: 570-297-1235