Provider Demographics
NPI:1215023510
Name:HYNDMAN AREA RESCUE SQUAD
Entity Type:Organization
Organization Name:HYNDMAN AREA RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-842-6398
Mailing Address - Street 1:892 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-4228
Mailing Address - Country:US
Mailing Address - Phone:800-280-5974
Mailing Address - Fax:724-234-4703
Practice Address - Street 1:164 MARKET STREET
Practice Address - Street 2:
Practice Address - City:HYNDMAN
Practice Address - State:PA
Practice Address - Zip Code:15545
Practice Address - Country:US
Practice Address - Phone:814-842-6755
Practice Address - Fax:814-842-6755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03228341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA590002475OtherRR MEDICARE
PA0007658810002Medicaid
PA590002475OtherRR MEDICARE