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General NPI Number Information
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NPI Number | 1902925860
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Entity Type | Organization
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Legal Business Name | BENTWORTH AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 6 DIAMOND WAY
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City | BENTLEYVILLE
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State | PA
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Zip | 15314-1997
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Country | US
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Telephone | 724-239-5521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 152 6 DIAMOND WAY
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City | BENTLEYVILLE
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State | PA
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Zip | 15314-0152
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Country | US
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Telephone | 724-239-5521
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL J VAHALY
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Credential |
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Telephone | 724-239-5512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 06038
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License Number State | PA
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