Provider Demographics
NPI:1568471084
Name:COOPERSBURG EMS
Entity Type:Organization
Organization Name:COOPERSBURG EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-282-8435
Mailing Address - Street 1:5 N MAIN ST REAR
Mailing Address - Street 2:P.O. BOX 162
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-1525
Mailing Address - Country:US
Mailing Address - Phone:610-282-8435
Mailing Address - Fax:
Practice Address - Street 1:5 N MAIN ST REAR
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-1525
Practice Address - Country:US
Practice Address - Phone:610-282-8435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA031223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1161083OtherKEYSTONE MERCY HEALTH PL
PA000000144012OtherUNISON HP
PA20010064OtherAMERIHEALTH MERCY HP
PA50004704OtherCAPITAL BLUE CROSS
PA1529392OtherGATEWAY HEALTH PLAN
PA215695OtherHIGHMARK
PA0731981000OtherINDEPENDENCE BLUE CROSS
PA0119137OtherAETNA
PA0119137OtherAETNA