MEDICARE: BURHOLME FIRST AID CORPS, 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	03330	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	0000130000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
3	0016408	OTHER	PA	AETNA US HEALTHCARE
4	0062672000	OTHER	PA	BLUE CROSS PERSONAL CHOIC
5	1005094	OTHER	PA	KEYSTONE MERCY

General Provider Information

NPI Number	:	1679576680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURHOLME FIRST AID CORPS, INC.

Provider Business Mailing Address
First Line	:	830 BLEIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3016
Country	:	US
Telephone Number	:	215-725-4030
Fax Number	:	215-745-3997

Provider Business Practice Location Address
First Line	:	830 BLEIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3016
Country	:	US
Telephone Number	:	215-725-4030
Fax Number	:	215-745-3997

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. CAROLE H FARLEY
Credential	:
Telephone Number	:	215-725-4030

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/24/2011

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