MEDICARE: NUREMBERG 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	04023	PA

General Provider Information

NPI Number	:	1235138108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUREMBERG COMMUNITY AMBULANCE ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 726
Second Line	:
City	:	NEW CUMBERLAND
State	:	PA
Zip	:	17070-0726
Country	:	US
Telephone Number	:	717-214-6018
Fax Number	:	717-214-6020

Provider Business Practice Location Address
First Line	:	HAZLE ST
Second Line	:
City	:	NUREMBERG
State	:	PA
Zip	:	18241
Country	:	US
Telephone Number	:	570-384-3405
Fax Number	:	570-384-3266

Authorized Official
Title or Position	:	CHIEF
Name	:	DAVE DEMSHOCK
Credential	:
Telephone Number	:	570-384-3405

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/11/2007

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