Provider Demographics
NPI:1053316398
Name:UNION COUNTY WEST END AMBULANCE ASSOCIATION INC
Entity Type:Organization
Organization Name:UNION COUNTY WEST END AMBULANCE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:PERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-922-1120
Mailing Address - Street 1:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:PA
Mailing Address - Zip Code:17835-0051
Mailing Address - Country:US
Mailing Address - Phone:570-922-1120
Mailing Address - Fax:570-922-0347
Practice Address - Street 1:3005 STATE ROUTE 235
Practice Address - Street 2:
Practice Address - City:MILLMONT
Practice Address - State:PA
Practice Address - Zip Code:17845-9561
Practice Address - Country:US
Practice Address - Phone:570-922-1120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA335609OtherHEALTH AMERICA/ASSURANCE
PA0009779270008Medicaid
PA335609OtherHEALTH AMERICA/ASSURANCE
PA0009779270008Medicaid