Healthcare Provider Details

I. General information

NPI: 1376517540
Provider Name (Legal Business Name): C&S AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 HOLLAND STREET
VANDERGRIFT PA
15690-1444
US

IV. Provider business mailing address

700 HOLLAND STREET
VANDERGRIFT PA
15690-1444
US

V. Phone/Fax

Practice location:
  • Phone: 724-568-3864
  • Fax: 724-794-1633
Mailing address:
  • Phone: 724-568-3864
  • Fax: 724-794-1633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number01058
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0011387790006
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier202414
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS/BLUE SHIELD
# 3
Identifier590005099
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerRR MEDICARE/PALMETTO GBA
# 4
Identifier109733
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH AMERICA/HEALTH ASS
# 5
Identifier5095190
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA
# 6
Identifier202414
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUNITED AMERICAN INSURANCE
# 7
Identifier70019
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUNISON
# 8
Identifier1010537
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGATEWAY HEALTH PLAN
# 9
Identifier201360
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUPMC HELATH PLAN

VIII. Authorized Official

Name: JAMES M CAPORALI
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 724-568-3864