MEDICARE: HARVEYS LAKE FIRE AND 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

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	:	1417064072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARVEYS LAKE FIRE AND AMBULANCE ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	HARVEYS LAKE
State	:	PA
Zip	:	18618-0056
Country	:	US
Telephone Number	:	570-639-1919
Fax Number	:

Provider Business Practice Location Address
First Line	:	1349 LAKESIDE DRIVE
Second Line	:
City	:	HARVEYS LAKE
State	:	PA
Zip	:	18618-3116
Country	:	US
Telephone Number	:	570-639-1919
Fax Number	:

Authorized Official
Title or Position	:	EMS CAPTAIN
Name	:	CHARLES WEST
Credential	:
Telephone Number	:	570-760-5506

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	12/30/2025

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