Provider Demographics
NPI:1427000603
Name:NEWFOUNDLAND AREA AMBULANCE ASSOCIATION
Entity Type:Organization
Organization Name:NEWFOUNDLAND AREA AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, BD.OF DIRECTORS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-676-4121
Mailing Address - Street 1:441 CRESTMONT DR
Mailing Address - Street 2:P.O.BOX 222
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18445-5203
Mailing Address - Country:US
Mailing Address - Phone:570-676-4121
Mailing Address - Fax:
Practice Address - Street 1:441 CRESTMONT DR
Practice Address - Street 2:
Practice Address - City:NEWFOUNDLAND
Practice Address - State:PA
Practice Address - Zip Code:18445-5203
Practice Address - Country:US
Practice Address - Phone:570-676-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040623416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA285683Medicare ID - Type Unspecified