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General NPI Number Information
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NPI Number | 1245298751
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Entity Type | Organization
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Legal Business Name | LAFAYETTE AMBULANCE AND RESCUE SQUAD, INC.
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 180 N HENDERSON RD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2123
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Country | US
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Telephone | 610-992-0399
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Fax | 610-992-0162
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Provider Business Mailing Address
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Address Line | 180 N HENDERSON RD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2123
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Country | US
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Telephone | 610-992-0399
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Fax | 610-992-0162
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Authorized Official
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Title or Position | EXECUTIVE MANAGER
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Name | MR. STEPHEN ROSKOS
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Credential |
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Telephone | 610-992-0399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 03158
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License Number State | PA
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