Basic Information
| Provider Information | |||||||||
| NPI: | 1669615217 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ORBISONIA-ROCKHILL EMERGENCY MEDICAL SERVICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 335 | ||||||||
| Address2: | |||||||||
| City: | ORBISONIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172430335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144479000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 VALLEY STREET | ||||||||
| Address2: | |||||||||
| City: | ROCKHILL FURNACE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144473221 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2009 | ||||||||
| LastUpdateDate: | 08/27/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOCKENBERRY | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 8144479000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | 04287 | PA | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 1023195750002 | 05 | PA | MEDICAID |