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General NPI Number Information
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NPI Number | 1093953176
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Entity Type | Organization
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Legal Business Name | BRADFORD AREA TRANSPORT SERVICE, LLC
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 17 HOLLEY AVE
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City | BRADFORD
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State | PA
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Zip | 16701-1809
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Country | US
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Telephone | 814-598-2089
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Fax | 814-368-8460
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Provider Business Mailing Address
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Address Line | 17 HOLLEY AVE
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City | BRADFORD
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State | PA
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Zip | 16701-1809
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Country | US
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Telephone | 814-598-2089
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Fax | 814-368-8460
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Authorized Official
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Title or Position | PRESIDENT
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Name | SALLY LYNN SCRIVO
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Credential | EMT
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Telephone | 814-598-1392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 09002
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License Number State | PA
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