Provider Demographics
NPI:1346308400
Name:WELLSPAN HEALTH - YORK HOSPITAL
Entity Type:Organization
Organization Name:WELLSPAN HEALTH - YORK HOSPITAL
Other - Org Name:DOVER AREA ALS
Other - Org Type:Other Name
Authorized Official - Title/Position:ALS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-851-3195
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-0726
Mailing Address - Country:US
Mailing Address - Phone:717-214-6018
Mailing Address - Fax:717-214-6020
Practice Address - Street 1:3700 DAVIDSBURG RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-4665
Practice Address - Country:US
Practice Address - Phone:717-851-3195
Practice Address - Fax:717-851-1569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05195341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001965470004Medicaid
PA1001965470004Medicaid