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General NPI Number Information
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NPI Number | 1669450334
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Entity Type | Organization
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Legal Business Name | EBENSBURG AREA AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 800 W HIGH ST
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City | EBENSBURG
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State | PA
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Zip | 15931-1804
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Country | US
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Telephone | 814-472-6700
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Fax | 814-472-9583
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Provider Business Mailing Address
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Address Line | 800 W HIGH ST
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City | EBENSBURG
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State | PA
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Zip | 15931-1804
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Country | US
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Telephone | 814-472-6700
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Fax | 814-472-9583
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BARRY A BLAKE
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Credential | NRP,CCEMTP
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Telephone | 814-472-6700
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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 | 06096
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License Number State | PA
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