MEDICARE: SUSQUEHANNA TOWNSHIP 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	22024	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	590001592	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000283280	OTHER	PA	BLUE SHIELD
2	10730	OTHER	PA	HEALTH ASSURANCE
3	30791	OTHER	PA	GEISINGER HEALTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	39EA05	OTHER	PA	CAPITAL BLUE CROSS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639250301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSQUEHANNA TOWNSHIP EMERGENCY MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	108 SHORT ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-3732
Country	:	US
Telephone Number	:	717-545-0842
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 SHORT ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-3732
Country	:	US
Telephone Number	:	717-545-0842
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ELLIOT MARKOVITZ
Credential	:
Telephone Number	:	717-545-0842

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/01/2012

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