Provider Demographics
NPI: | 1225053002 |
---|---|
Name: | HOPS AMBULANCE ASSOCIATION |
Entity Type: | Organization |
Organization Name: | HOPS AMBULANCE ASSOCIATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | TREASURER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SEIPLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 570-744-1700 |
Mailing Address - Street 1: | 606 RIDGE RD |
Mailing Address - Street 2: | |
Mailing Address - City: | ROME |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18837-7914 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 570-744-1700 |
Mailing Address - Fax: | 570-247-7355 |
Practice Address - Street 1: | 6185 HERRICKVILLE RD |
Practice Address - Street 2: | |
Practice Address - City: | WYALUSING |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18853 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-744-1700 |
Practice Address - Fax: | 570-247-7355 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-13 |
Last Update Date: | 2012-08-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3416L0300X | Transportation Services | Ambulance | Land Transport |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 0009058840003 | Medicaid | |
PA | 286805 | Medicare PIN |