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General NPI Number Information
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NPI Number | 1871591545
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Entity Type | Organization
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Legal Business Name | FORKS TOWNSHIP EMERGENCY SQUAD
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2016 SULLIVAN TRL
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City | EASTON
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State | PA
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Zip | 18040-8338
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Country | US
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Telephone | 610-253-7416
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Fax | 610-253-9550
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Provider Business Mailing Address
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Address Line | PO BOX 284
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City | EASTON
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State | PA
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Zip | 18044-0284
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Country | US
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Telephone | 610-253-7416
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Fax | 610-253-9550
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | MS. DIANNE L NUTTALL
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Credential |
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Telephone | 610-253-7416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 04112
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License Number State | PA
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