MEDICARE: POTTSVILLE AREA EMERGENCY MEDICAL SERVICES, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080249800	OTHER	PA	FEDERAL BLACK LUNG PROGRAM
2	34971	OTHER	PA	HEALTH PARTNERS
3	1503196	OTHER	PA	GATEWAY HEALTH PLAN
4	216669	OTHER	PA	HIGHMARK BLUE SHIELD
5	50004344	OTHER	PA	CAPITAL BLUE CROSS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	P023290	OTHER	PA	TRICARE
8	20010626	OTHER	AR	AMERIHEALTH CARITAS
9	30009167	OTHER	PA	KEYSTONE MERCY HEALTH PLAN
10	080249800	OTHER	PA	US DEPARTMENT OF LABOR
11	653509	OTHER	PA	VICTIM'S COMPENSATION

General Provider Information

NPI Number	:	1205837267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTTSVILLE AREA EMERGENCY MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	320 N 9TH ST
Second Line	:
City	:	POTTSVILLE
State	:	PA
Zip	:	17901-2346
Country	:	US
Telephone Number	:	570-622-9647
Fax Number	:	570-622-9648

Provider Business Practice Location Address
First Line	:	320 N 9TH ST
Second Line	:
City	:	POTTSVILLE
State	:	PA
Zip	:	17901-2346
Country	:	US
Telephone Number	:	570-622-9647
Fax Number	:	570-622-9648

Authorized Official
Title or Position	:	SECRETARY
Name	:	MR. GARRY THOMAS LAUBACH
Credential	:
Telephone Number	:	570-622-9647

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	04/08/2026

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