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General NPI Number Information
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NPI Number | 1437226420
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Entity Type | Organization
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Legal Business Name | FAYETTE EMS
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 301 S ARCH ST
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3521
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Country | US
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Telephone | 724-628-8610
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Fax | 724-628-2533
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Provider Business Mailing Address
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Address Line | PO BOX 862 301 ARCH SREET
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-0862
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Country | US
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Telephone | 724-628-8610
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Fax | 724-628-2533
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | BOB TOPPER
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Credential |
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Telephone | 724-628-8610
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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 | 26215
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License Number State | PA
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