Provider Demographics
NPI:1427013317
Name:CONEMAUGH TOWNSHIP EMS, INC
Entity Type:Organization
Organization Name:CONEMAUGH TOWNSHIP EMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUPARCIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-288-1990
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:TIRE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:15959-0363
Mailing Address - Country:US
Mailing Address - Phone:814-288-1990
Mailing Address - Fax:814-288-1981
Practice Address - Street 1:1075 TIRE HILL RD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-7706
Practice Address - Country:US
Practice Address - Phone:814-288-1990
Practice Address - Fax:814-288-1981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA560083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA590009464OtherRAILROAD MEDICARE
PA264361200OtherFED BLACK LUNG
PA1041073OtherGATEWAY
PA216546OtherHIGHMARK
PA0014856400001Medicaid
PA216546OtherHIGHMARK