Provider Demographics
NPI:1275650939
Name:ORWIGSBURG AMBULANCE INC
Entity Type:Organization
Organization Name:ORWIGSBURG AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTORS PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-739-4456
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-0004
Mailing Address - Country:US
Mailing Address - Phone:570-366-2331
Mailing Address - Fax:570-366-0519
Practice Address - Street 1:500 E MARKET ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-2050
Practice Address - Country:US
Practice Address - Phone:570-366-2331
Practice Address - Fax:570-366-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040453416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007318920003Medicaid
PA283927Medicare ID - Type Unspecified