MEDICARE: WAKEFIELD 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	341600000X	Ambulance	03377	PA
2	3416L0300X	Land Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590009341	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0706361	OTHER		UPMC

General Provider Information

NPI Number	:	1588600977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAKEFIELD AMBULANCE ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 86
Second Line	:
City	:	PEACH BOTTOM
State	:	PA
Zip	:	17563-0086
Country	:	US
Telephone Number	:	717-464-0724
Fax Number	:	717-464-9775

Provider Business Practice Location Address
First Line	:	2272 ROBERT FULTON HWY
Second Line	:
City	:	PEACH BOTTOM
State	:	PA
Zip	:	17563-9701
Country	:	US
Telephone Number	:	717-955-0152
Fax Number	:	717-955-0153

Authorized Official
Title or Position	:	TREASURER
Name	:	BRENDA SLAUCH
Credential	:
Telephone Number	:	717-464-0724

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	05/28/2024

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Directions to “WAKEFIELD AMBULANCE ASSOCIATION ” Practice Location

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