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General NPI Number Information
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NPI Number | 1609846492
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Entity Type | Organization
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Legal Business Name | IRVONA VOLUNTEER AMBULANCE SERVICES
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 130 JULIA STREET
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City | IRVONA
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State | PA
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Zip | 16656-0151
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Country | US
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Telephone | 814-672-3751
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Fax | 814-672-3751
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Provider Business Mailing Address
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Address Line | PO BOX 151
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City | IRVONA
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State | PA
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Zip | 16656-0151
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Country | US
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Telephone | 814-672-3751
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Fax | 814-672-3751
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Authorized Official
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Title or Position | AMBULANCE SUPERVISOR / TREASURER
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Name | MR. JEFF KENNEDY
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Credential |
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Telephone | 814-672-3751
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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 | 05088 PA DEPT OF HEA
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License Number State | PA
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