Provider Demographics
NPI:1154303212
Name:AMBULANCE AND CHAIR EMS, INC
Entity Type:Organization
Organization Name:AMBULANCE AND CHAIR EMS, INC
Other - Org Name:LEELYNNANN INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BOARD CHAIRPERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:PANTUSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-250-6378
Mailing Address - Street 1:75 BRADEN STREET
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4001
Mailing Address - Country:US
Mailing Address - Phone:724-225-8050
Mailing Address - Fax:724-225-2173
Practice Address - Street 1:75 BRADEN STREET
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4001
Practice Address - Country:US
Practice Address - Phone:724-225-8050
Practice Address - Fax:724-225-2173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA030403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007493250006Medicaid
PA280026Medicare ID - Type Unspecified