MEDICARE: EAST BRADY AREA AMBULANCE

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	16013	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
2	1038097	OTHER	PA	GATEWAY

General Provider Information

NPI Number	:	1366566465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST BRADY AREA AMBULANCE

Provider Business Mailing Address
First Line	:	PO BOX 325
Second Line	:	426 KELLYS WAY
City	:	EAST BRADY
State	:	PA
Zip	:	16028-0325
Country	:	US
Telephone Number	:	724-526-5065
Fax Number	:	724-526-3532

Provider Business Practice Location Address
First Line	:	426 KELLYS WAY
Second Line	:
City	:	EAST BRADY
State	:	PA
Zip	:	16028-0325
Country	:	US
Telephone Number	:	724-526-5065
Fax Number	:	724-526-3532

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAMELA RYAN
Credential	:
Telephone Number	:	724-526-5065

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	08/22/2020

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Directions to “EAST BRADY AREA AMBULANCE ” Practice Location

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