MEDICARE: LIBERTY EMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	341600000X	Ambulance
2	343900000X	Non-emergency Medical Transport (VAN)
3	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1770827925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY EMS

Provider Business Mailing Address
First Line	:	614 BRIDGETON RD
Second Line	:
City	:	FAWN GROVE
State	:	PA
Zip	:	17321-9350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	614 BRIDGETON RD
Second Line	:
City	:	FAWN GROVE
State	:	PA
Zip	:	17321-9350
Country	:	US
Telephone Number	:	443-536-4077
Fax Number	:

Authorized Official
Title or Position	:	CEO/ PRESIDENT
Name	:	MR. EDWARD FREDRICK SENKBEIL
Credential	:
Telephone Number	:	443-789-7442

Provider Enumeration Date	:	11/11/2012
Last Update Date	:	03/28/2014

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Directions to “LIBERTY EMS ” Practice Location

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