Provider Demographics
NPI:1407832215
Name:LEHIGHTON AMBULANCE ASSOCIATION INC
Entity Type:Organization
Organization Name:LEHIGHTON AMBULANCE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JARAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YEASTEDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-377-5155
Mailing Address - Street 1:516 IRON ST
Mailing Address - Street 2:P.O. BOX 82
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-1913
Mailing Address - Country:US
Mailing Address - Phone:610-377-5155
Mailing Address - Fax:610-377-5576
Practice Address - Street 1:516 IRON ST
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-1913
Practice Address - Country:US
Practice Address - Phone:610-377-5155
Practice Address - Fax:610-377-5576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03396341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016063890004Medicaid
PA0016063890004Medicaid