Provider Demographics
NPI:1427038660
Name:HOUTDALE EMERGENCY MEDICAL SERVICES
Entity Type:Organization
Organization Name:HOUTDALE EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPT.
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:TORMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-378-8622
Mailing Address - Street 1:816 ELIZABETH ST
Mailing Address - Street 2:PO BOX 224
Mailing Address - City:HOUTZDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16651-1322
Mailing Address - Country:US
Mailing Address - Phone:814-378-8622
Mailing Address - Fax:
Practice Address - Street 1:816 ELIZABETH STREET BOX 224
Practice Address - Street 2:
Practice Address - City:HOUTZDALE
Practice Address - State:PA
Practice Address - Zip Code:16651-1322
Practice Address - Country:US
Practice Address - Phone:814-378-8622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-21
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA170123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA189523647OtherPEBTF
PA089491900OtherBLACK LUNG
PA000204441OtherHIGHMARK
PA0010750150003Medicaid
PA216161OtherUPMC FOR YOU
PA590006782OtherRR MEDICARE
PA1007200086OtherUNITED HEALTH
PA204441OtherUMWA
PA204441OtherUMWA
PA0010750150003Medicaid