Provider Demographics
NPI:1437149564
Name:ROSTRAVER WEST NEWTON EMS
Entity Type:Organization
Organization Name:ROSTRAVER WEST NEWTON EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:COMINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-929-9116
Mailing Address - Street 1:PO BOX 603
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-0603
Mailing Address - Country:US
Mailing Address - Phone:724-929-9116
Mailing Address - Fax:724-929-3159
Practice Address - Street 1:100 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-4002
Practice Address - Country:US
Practice Address - Phone:724-929-9116
Practice Address - Fax:724-929-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA041623416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010642360006Medicaid
PA1004361OtherGATEWAY
PA103703OtherUPMC FOR LIFE MEDICARE
PA333404OtherADVANTRA
PA333404OtherADVANTRA