MEDICARE: SHENANDOAH COMMUNITY 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	3416L0300X	Land Ambulance	01291	PA

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	:	1124010293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHENANDOAH COMMUNITY AMBULANCE ASSOCIATION

Provider Business Mailing Address
First Line	:	229 N MAIN ST
Second Line	:
City	:	SHENANDOAH
State	:	PA
Zip	:	17976-1705
Country	:	US
Telephone Number	:	570-462-0500
Fax Number	:	570-462-1657

Provider Business Practice Location Address
First Line	:	229 N MAIN ST
Second Line	:
City	:	SHENANDOAH
State	:	PA
Zip	:	17976-1705
Country	:	US
Telephone Number	:	570-462-0500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD EXAMITAS
Credential	:
Telephone Number	:	570-462-0500

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	12/30/2025

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