Provider Demographics
NPI:1417089285
Name:FOXWALL EMERGENCY MEDICAL SERVICE, INC.
Entity Type:Organization
Organization Name:FOXWALL EMERGENCY MEDICAL SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-963-6611
Mailing Address - Street 1:145 SQUAW RUN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2344
Mailing Address - Country:US
Mailing Address - Phone:412-963-6611
Mailing Address - Fax:412-963-6851
Practice Address - Street 1:145 SQUAW RUN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2344
Practice Address - Country:US
Practice Address - Phone:412-963-6611
Practice Address - Fax:412-963-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA285207Medicare ID - Type UnspecifiedPROVIDER NUMBER