Provider Demographics
NPI:1275755522
Name:PERRYOPOLIS AMBULANCE SERVICE
Entity Type:Organization
Organization Name:PERRYOPOLIS AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEANGELIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-736-8124
Mailing Address - Street 1:321 INDEPENDENCE
Mailing Address - Street 2:
Mailing Address - City:PERRYOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15473
Mailing Address - Country:US
Mailing Address - Phone:724-736-8124
Mailing Address - Fax:
Practice Address - Street 1:321 INDEPENDENCE
Practice Address - Street 2:
Practice Address - City:PERRYOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15473
Practice Address - Country:US
Practice Address - Phone:724-736-8124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA26020341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00010298180001Medicaid