Provider Demographics
NPI:1114030350
Name:BROWNSVILLE AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:BROWNSVILLE AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:EMTP
Authorized Official - Phone:724-785-6637
Mailing Address - Street 1:12 ARCH ST
Mailing Address - Street 2:BOX 300
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-1611
Mailing Address - Country:US
Mailing Address - Phone:724-785-6558
Mailing Address - Fax:724-785-4404
Practice Address - Street 1:12 ARCH ST
Practice Address - Street 2:BOX 300
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-1611
Practice Address - Country:US
Practice Address - Phone:724-785-6558
Practice Address - Fax:724-785-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05143341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA332698OtherHEALTH AMERICA
PA0007373680001Medicaid
PA000590130832Medicare ID - Type UnspecifiedRAILROAD MEDICARE
PA0007373680001Medicaid