MEDICARE: PENN MAHONING AMBULANCE ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance
2	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063452324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENN MAHONING AMBULANCE ASSOCIATION

Provider Business Mailing Address
First Line	:	P.O.BOX 135
Second Line	:
City	:	ANDREAS
State	:	PA
Zip	:	18211-0135
Country	:	US
Telephone Number	:	570-386-2233
Fax Number	:	570-386-4128

Provider Business Practice Location Address
First Line	:	1748 WEST PENN PIKE
Second Line	:
City	:	NEW RINGGOLD
State	:	PA
Zip	:	17960-9401
Country	:	US
Telephone Number	:	570-386-2233
Fax Number	:	570-386-4128

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VALERIE COOMBE
Credential	:	EMT/B
Telephone Number	:	570-386-2233

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	01/20/2024

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