Provider Demographics
NPI:1497874259
Name:SUGARLOAF COMMUNITY RESCUE & AMBULANCE ASSOCIATION
Entity Type:Organization
Organization Name:SUGARLOAF COMMUNITY RESCUE & AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-925-5824
Mailing Address - Street 1:987 ELK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:PA
Mailing Address - Zip Code:17814-7404
Mailing Address - Country:US
Mailing Address - Phone:570-925-5824
Mailing Address - Fax:
Practice Address - Street 1:987 ELK GROVE RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:PA
Practice Address - Zip Code:17814-7404
Practice Address - Country:US
Practice Address - Phone:570-925-5824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA973303416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7179231Medicaid
PA216116Medicare ID - Type UnspecifiedMEDICARE