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General NPI Number Information
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NPI Number | 1952436503
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Entity Type | Organization
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Legal Business Name | PORTAGE AREA AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 655 NORTH RAILROAD AVE
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City | PORTAGE
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State | PA
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Zip | 15946-0237
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Country | US
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Telephone | 814-241-9663
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Fax | 724-794-1633
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Provider Business Mailing Address
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Address Line | P O BOX 237
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City | PORTAGE
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State | PA
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Zip | 15946-0237
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Country | US
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Telephone | 800-280-5974
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Fax | 724-794-1633
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. CHARLES RIMINI
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Credential |
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Telephone | 814-241-9663
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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 | 05114
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License Number State | PA
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