Provider Demographics
NPI:1508901562
Name:GREENSBORO & MONONGAHELA TWP VFD
Entity Type:Organization
Organization Name:GREENSBORO & MONONGAHELA TWP VFD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE COMMANDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-943-3800
Mailing Address - Street 1:4158 OLD WILLIAM PENN HIGHWAY
Mailing Address - Street 2:DEPENDABLE AMBULANCE BILLING LLC
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668
Mailing Address - Country:US
Mailing Address - Phone:724-325-4003
Mailing Address - Fax:724-325-1603
Practice Address - Street 1:416 FRONT STREET
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:PA
Practice Address - Zip Code:15338
Practice Address - Country:US
Practice Address - Phone:724-943-3800
Practice Address - Fax:724-943-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA041583416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000816292003Medicaid