Provider Demographics
NPI:1205812823
Name:COMMUNITY AMBULANCE ASSOCIATION OF AMBLER
Entity Type:Organization
Organization Name:COMMUNITY AMBULANCE ASSOCIATION OF AMBLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-643-6517
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:1414 E BUTLER PIKE
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002
Mailing Address - Country:US
Mailing Address - Phone:215-643-6517
Mailing Address - Fax:215-643-5212
Practice Address - Street 1:1414 E BUTLER PIKE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-3764
Practice Address - Country:US
Practice Address - Phone:215-643-6517
Practice Address - Fax:215-643-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-15
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA031463416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007173830003Medicaid
PA0007173830003Medicaid