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General NPI Number Information
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NPI Number | 1134266141
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Entity Type | Organization
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Legal Business Name | SAINT CLAIR VETERANS MEMORIAL AMBULANCE FUND
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 45 N 2ND ST # 47
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City | SAINT CLAIR
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State | PA
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Zip | 17970-1027
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Country | US
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Telephone | 570-429-1388
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Fax | 570-429-0655
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Provider Business Mailing Address
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Address Line | PO BOX 124
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City | SAINT CLAIR
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State | PA
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Zip | 17970-0124
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Country | US
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Telephone | 570-429-1388
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Fax | 570-429-0655
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Authorized Official
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Title or Position | EXECUTIVE CHIEF
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Name | MR. STEPHEN BOBELLA
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Credential |
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Telephone | 570-429-1388
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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 | 04046
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License Number State | PA
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