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General NPI Number Information
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NPI Number | 1720271364
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Entity Type | Organization
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Legal Business Name | BRADFORD Z STAT AMBULANCE, LLC.
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 123 S KENDALL AVE
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City | BRADFORD
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State | PA
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Zip | 16701-3617
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Country | US
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Telephone | 814-598-1392
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Fax | 814-368-8460
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Provider Business Mailing Address
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Address Line | 123 S KENDALL AVE
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City | BRADFORD
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State | PA
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Zip | 16701-3617
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Country | US
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Telephone | 814-598-1392
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Fax | 814-368-8460
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SALLY LYNN SCRIVO
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Credential |
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Telephone | 814-598-1392
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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 | 100069992/000
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License Number State | PA
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