Basic Information
| Provider Information | |||||||||
| NPI: | 1649366782 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SINNAMAHONING VOL FIRE DEPT AND AMBULANCE SERVICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 207 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181050207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4846642007 | ||||||||
| FaxNumber: | 4846642015 | ||||||||
| Practice Location | |||||||||
| Address1: | 186 RAILROAD STREET | ||||||||
| Address2: | |||||||||
| City: | SINNAMAHONING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145462487 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 09/28/2007 | ||||||||
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| AuthorizedOfficialLastName: | KEHL | ||||||||
| AuthorizedOfficialFirstName: | MELVIN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8145462487 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | 06087 | PA | Y | Transportation Services | Ambulance |
ID Information
| ID | Type | State | Issuer | Description | 0008958860002 | 05 | PA | MEDICAID |