Provider Demographics
NPI:1225209646
Name:FIREMANS AMBULANCE SERVICE TEAM
Entity Type:Organization
Organization Name:FIREMANS AMBULANCE SERVICE TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELLOMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-923-1446
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:RENOVO
Mailing Address - State:PA
Mailing Address - Zip Code:17764-0163
Mailing Address - Country:US
Mailing Address - Phone:570-923-1446
Mailing Address - Fax:
Practice Address - Street 1:800 HURON AVE
Practice Address - Street 2:
Practice Address - City:RENOVO
Practice Address - State:PA
Practice Address - Zip Code:17764-1140
Practice Address - Country:US
Practice Address - Phone:570-923-1446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA280162Medicare PIN