Provider Demographics
NPI:1275523441
Name:WILLIAM CAMERON ENGINE COMPANY OF LEWISBURG PENNSYLVANIA
Entity Type:Organization
Organization Name:WILLIAM CAMERON ENGINE COMPANY OF LEWISBURG PENNSYLVANIA
Other - Org Name:WILLIAM CAMERON ENGINE COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CATHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-524-2291
Mailing Address - Street 1:239 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1411
Mailing Address - Country:US
Mailing Address - Phone:570-524-2291
Mailing Address - Fax:570-524-6831
Practice Address - Street 1:11 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1124
Practice Address - Country:US
Practice Address - Phone:570-524-2291
Practice Address - Fax:570-524-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA041973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011206020002Medicaid
PA282167Medicare ID - Type Unspecified