Provider Demographics
NPI:1376538793
Name:NOGA AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:NOGA AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMALOU
Authorized Official - Middle Name:
Authorized Official - Last Name:NOGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-652-8300
Mailing Address - Street 1:2615 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1505
Mailing Address - Country:US
Mailing Address - Phone:724-652-8300
Mailing Address - Fax:724-656-0794
Practice Address - Street 1:2615 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1505
Practice Address - Country:US
Practice Address - Phone:724-652-8300
Practice Address - Fax:724-656-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA370183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007091300001Medicaid
PA0007091300001Medicaid