Basic Information
| Provider Information | |||||||||
| NPI: | 1912998758 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SPRINGFIELD TOWNSHIP AMBULANCE ASSOCIATION | ||||||||
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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: | 1510 PAPER MILL RD | ||||||||
| Address2: | |||||||||
| City: | WYNDMOOR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190387032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152331812 | ||||||||
| FaxNumber: | 2152332400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2005 | ||||||||
| LastUpdateDate: | 10/30/2007 | ||||||||
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| AuthorizedOfficialLastName: | BRADLEY | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2152647858 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | 05027 | PA | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 0049096000 | 01 | KEYSTONE W SECURITY | OTHER | 0016357290005 | 05 | PA | MEDICAID | 284725 | 01 | PA | INDEPENDENCE BCBS OF PA | OTHER | 07994 | 01 | HEALTH PARTNERS HMO DPA | OTHER | 07994 | 01 | SENIOR PARTNERS HMO MDC | OTHER | 284725 | 01 | PA | BCBS OF PA BLUE SHIELD | OTHER | 60692 | 01 | KEYSTONE MERCY HMO DPA | OTHER |