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General NPI Number Information
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NPI Number | 1841200680
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Entity Type | Organization
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Legal Business Name | ST. MARYS AREA AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 773 JOHNSONBURG RD
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City | SAINT MARYS
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State | PA
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Zip | 15857-3417
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Country | US
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Telephone | 814-781-1571
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Fax | 814-781-8330
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Provider Business Mailing Address
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Address Line | PO BOX 2021
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City | INDIANA
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State | PA
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Zip | 15701-5521
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Country | US
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Telephone | 800-440-6257
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Fax | 724-349-3480
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. ROBERT JOHN SORG
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Credential |
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Telephone | 814-781-1571
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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 | 05046
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License Number State | PA
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