{
"Npi": {
"NPI": "1609846492",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "IRVONA VOLUNTEER AMBULANCE SERVICES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 151",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IRVONA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "16656-0151",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-672-3751",
"MailingAddressFaxNumber": "814-672-3751",
"FirstLinePracticeLocationAddress": "130 JULIA STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "IRVONA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "16656-0151",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "814-672-3751",
"PracticeLocationAddressFaxNumber": "814-672-3751",
"EnumerationDate": "01/24/2006",
"LastUpdateDate": "09/28/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KENNEDY",
"AuthorizedOfficialFirstName": "JEFF",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "AMBULANCE SUPERVISOR / TREASURER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "814-672-3751",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "05088 PA DEPT OF HEA",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}