=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851704290
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIHI EMS AMBULANCE SERVICE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2014
-----------------------------------------------------
Last Update Date | 06/03/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 819 MAIN ST
-----------------------------------------------------
City | WATSONTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17777-1415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-538-4488
-----------------------------------------------------
Fax | 570-538-1870
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14210 WHITTIER BLVD
-----------------------------------------------------
City | WHITTIER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90605-2101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-947-2795
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. RANDY HIGASHI
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 562-947-2795
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------