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General NPI Number Information
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NPI Number | 1821122235
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Entity Type | Organization
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Legal Business Name | LOWER ALSACE VOLUNTEER AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 750 N 25TH ST
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City | READING
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State | PA
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Zip | 19606-1400
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Country | US
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Telephone | 610-779-0190
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Fax | 610-779-9143
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Provider Business Mailing Address
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Address Line | 750 N 25TH ST
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City | READING
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State | PA
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Zip | 19606-1400
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Country | US
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Telephone | 610-779-0190
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Fax | 610-779-9143
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. CAROL WENTZEL
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Credential |
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Telephone | 610-779-0190
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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 | 06098
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License Number State | PA
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