Healthcare Provider Details

I. General information

NPI: 1326014804
Provider Name (Legal Business Name): YOUNGSVILLE VFD AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 EAST MAIN STREET
YOUNGSVILLE PA
16371-1124
US

IV. Provider business mailing address

PO BOX 207
ALLENTOWN PA
18105-0207
US

V. Phone/Fax

Practice location:
  • Phone: 814-563-4455
  • Fax: 814-563-3334
Mailing address:
  • Phone: 484-664-2007
  • Fax: 484-664-2017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number6201001
License Number StatePA

VIII. Authorized Official

Name: MR. SCOTT L ROSE
Title or Position: PRESIDENT
Credential:
Phone: 814-563-4455