Provider Demographics
NPI:1033283726
Name:THOMPSONTOWN AMBULANCE LEAGUE
Entity Type:Organization
Organization Name:THOMPSONTOWN AMBULANCE LEAGUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:HOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-436-9535
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:3 CEDAR COURT
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-0098
Mailing Address - Country:US
Mailing Address - Phone:717-728-9223
Mailing Address - Fax:717-728-9344
Practice Address - Street 1:STATE AND TANNER STREET
Practice Address - Street 2:
Practice Address - City:THOMPSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17094
Practice Address - Country:US
Practice Address - Phone:717-535-4519
Practice Address - Fax:717-535-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010815220005Medicaid
PA202015Medicare ID - Type UnspecifiedMEDICARE