Provider Demographics
NPI:1306825765
Name:BEAR CREEK BUCK TOWNSHIP AMBULANCE ASSOCIATION
Entity Type:Organization
Organization Name:BEAR CREEK BUCK TOWNSHIP AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-825-7111
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-0207
Mailing Address - Country:US
Mailing Address - Phone:484-664-2007
Mailing Address - Fax:484-664-2015
Practice Address - Street 1:3335 BEAR CREEK BLVD
Practice Address - Street 2:
Practice Address - City:BEAR CREEK TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18702-9760
Practice Address - Country:US
Practice Address - Phone:570-825-7111
Practice Address - Fax:570-825-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA400473416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014856030003Medicaid
080161OtherFIRST PRIORITY HEALTH
200371OtherBC BS OF PA BLUE SHIELD
232402644OtherBC OF NE PA
232402644OtherPA TURNPIKE COMMISION
833809OtherUMWA HEALTH RETIREMENT
0021908OtherAETNA USHC BLUE BELL HMO
590011745OtherUNITED HC RR MEDICARE
232402644OtherHEALTHMATE HMO DPA
232402644OtherPA TURNPIKE COMMISION