Provider Demographics
NPI:1295835536
Name:VETERANS OF FOREIGN WARS OF THE UNITED STATES DEPT OF PENNSYLVANIA
Entity Type:Organization
Organization Name:VETERANS OF FOREIGN WARS OF THE UNITED STATES DEPT OF PENNSYLVANIA
Other - Org Name:PETERS TOWNSHIP VFW 764 AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, EMT
Authorized Official - Phone:724-941-4700
Mailing Address - Street 1:300 MUNICIPAL DR
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3442
Mailing Address - Country:US
Mailing Address - Phone:724-941-4700
Mailing Address - Fax:724-942-2522
Practice Address - Street 1:300 MUNICIPAL DR
Practice Address - Street 2:
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3442
Practice Address - Country:US
Practice Address - Phone:724-941-4700
Practice Address - Fax:724-942-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA021163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012047850002Medicaid
PA281254Medicare ID - Type Unspecified