Provider Demographics
NPI:1386635704
Name:EASTERN AREA PREHOSPITAL SERVICE
Entity Type:Organization
Organization Name:EASTERN AREA PREHOSPITAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W T
Authorized Official - Last Name:SHURGOT
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:412-829-8155
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145-0172
Mailing Address - Country:US
Mailing Address - Phone:412-829-8155
Mailing Address - Fax:412-824-9955
Practice Address - Street 1:192 11TH ST
Practice Address - Street 2:
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145-1812
Practice Address - Country:US
Practice Address - Phone:412-829-8155
Practice Address - Fax:412-824-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA030903416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007038890002Medicaid
PA0007038890002Medicaid