Basic Information
| Provider Information | |||||||||
| NPI: | 1811908973 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEW RINGGOLD AMBULANCE INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NEW RINGGOLD AREA EMS INC | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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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: | 115 NORTH RAILROAD STREET | ||||||||
| Address2: | |||||||||
| City: | NEW RINGGOLD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5709432272 | ||||||||
| FaxNumber: | 5709432802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 02/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | ECKROTH | ||||||||
| AuthorizedOfficialFirstName: | EMILY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT CHEIF | ||||||||
| AuthorizedOfficialTelephone: | 5709432272 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 1014945800001 | 05 | PA | MEDICAID |