Basic Information
| Provider Information | |||||||||
| NPI: | 1710974134 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HILLTOP VOL FIRE DEPT AMB | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 207 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181050207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004732278 | ||||||||
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| Practice Location | |||||||||
| Address1: | RT 646 | ||||||||
| Address2: | |||||||||
| City: | CYCLONE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144653321 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHEFFER | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
| AuthorizedOfficialMiddleName: | LEE | ||||||||
| AuthorizedOfficialTitleorPosition: | AMBULANCE CAPTAIN | ||||||||
| AuthorizedOfficialTelephone: | 8144653321 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | 04109 | PA | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 0012277430001 | 05 | PA | MEDICAID | 216162 | 01 | PA | BCBS | OTHER | 219473 | 01 | UPMC HEALTH PLAN COMMERCI | OTHER |