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General NPI Number Information
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NPI Number | 1588952246
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Entity Type | Organization
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Legal Business Name | EXCELSIOR EMS LLC
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 7 W BETHANY RD
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City | NEWMANSTOWN
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State | PA
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Zip | 17073-9191
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Country | US
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Telephone | 610-757-1153
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Fax | 610-757-1154
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Provider Business Mailing Address
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Address Line | 7 W BETHANY RD
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City | NEWMANSTOWN
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State | PA
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Zip | 17073-9191
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Country | US
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Telephone | 610-757-1153
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Fax | 610-757-1154
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | SHAWN M HICKERNELL
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Credential |
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Telephone | 610-757-1153
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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 |
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License Number State |
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