Provider Demographics
NPI:1003800111
Name:EASTON EMERGENCY SQUAD
Entity Type:Organization
Organization Name:EASTON EMERGENCY SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-258-2866
Mailing Address - Street 1:908 PACKER ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-7360
Mailing Address - Country:US
Mailing Address - Phone:610-258-2866
Mailing Address - Fax:610-258-1153
Practice Address - Street 1:908 PACKER ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-7360
Practice Address - Country:US
Practice Address - Phone:610-258-2866
Practice Address - Fax:610-258-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04316341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA285744Medicare ID - Type UnspecifiedAMBULANCE