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General NPI Number Information
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NPI Number | 1790993186
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Entity Type | Organization
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Legal Business Name | FRACKVILLE COMMUNITY AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 52 E ARCH ST
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City | FRACKVILLE
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State | PA
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Zip | 17931-2207
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Country | US
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Telephone | 570-874-2955
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Fax | 570-874-7436
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Provider Business Mailing Address
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Address Line | PO BOX 15
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City | FRACKVILLE
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State | PA
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Zip | 17931-0015
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Country | US
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Telephone | 570-874-2955
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Fax | 570-874-7436
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Authorized Official
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Title or Position | FINANCIAL SECRETARY/TREASURER
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Name | MR. LEO R LUCIANI
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Credential |
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Telephone | 570-874-2955
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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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