Basic Information
| Provider Information | |||||||||
| NPI: | 1992785646 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MAHONING VALLEY AMBULANCE ASSOCIATION, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 MILL RD | ||||||||
| Address2: | |||||||||
| City: | LEHIGHTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182359667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703862518 | ||||||||
| FaxNumber: | 5703863268 | ||||||||
| Practice Location | |||||||||
| Address1: | 902 MILL RD | ||||||||
| Address2: | |||||||||
| City: | LEHIGHTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182359667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703862518 | ||||||||
| FaxNumber: | 5703863268 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | WALTER | ||||||||
| AuthorizedOfficialTitleorPosition: | TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 5703865800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | 13006 | PA | Y | Transportation Services | Ambulance |
No ID Information.