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General NPI Number Information
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NPI Number | 1811066186
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Entity Type | Organization
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Legal Business Name | LOWER KISKI AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 80 KISKI AVENUE
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City | LEECHBURG
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State | PA
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Zip | 15656-0397
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Country | US
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Telephone | 724-845-8504
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Fax | 724-845-8237
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Provider Business Mailing Address
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Address Line | 80 KISKI AVE PO BOX 397
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City | LEECHBURG
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State | PA
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Zip | 15656-0397
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Country | US
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Telephone | 724-845-8504
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Fax | 724-845-8237
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | ADOLPH POLI
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Credential |
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Telephone | 724-845-8504
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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 | 05223
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License Number State | PA
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