Provider Demographics
NPI:1437132347
Name:MCADOO FIRE COMPANY AMBULANCE ASSOCIATION, INC
Entity Type:Organization
Organization Name:MCADOO FIRE COMPANY AMBULANCE ASSOCIATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:LESHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-929-2042
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:MCADOO
Mailing Address - State:PA
Mailing Address - Zip Code:18237-0097
Mailing Address - Country:US
Mailing Address - Phone:570-929-2042
Mailing Address - Fax:
Practice Address - Street 1:34 S KENNEDY DR
Practice Address - Street 2:
Practice Address - City:MCADOO
Practice Address - State:PA
Practice Address - Zip Code:18237-1806
Practice Address - Country:US
Practice Address - Phone:570-929-2042
Practice Address - Fax:570-929-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012365000003Medicaid
PA200405Medicare PIN