Provider Demographics
NPI:1093769267
Name:MCCANDLESS-FRANKLIN PARK AMBULANCE AUTHORITY
Entity Type:Organization
Organization Name:MCCANDLESS-FRANKLIN PARK AMBULANCE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-367-5883
Mailing Address - Street 1:9925 GRUBBS RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9644
Mailing Address - Country:US
Mailing Address - Phone:412-367-5883
Mailing Address - Fax:412-367-8147
Practice Address - Street 1:9925 GRUBBS RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:412-367-5883
Practice Address - Fax:412-367-8147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA060173416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007936340001Medicaid
PA0007936340001Medicaid