Provider Demographics
NPI:1588641179
Name:MILTON AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:MILTON AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REGAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:YODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-742-9516
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:PA
Mailing Address - Zip Code:17847-0275
Mailing Address - Country:US
Mailing Address - Phone:570-742-9516
Mailing Address - Fax:570-742-1391
Practice Address - Street 1:CAMERON AVE & CHERRY ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:PA
Practice Address - Zip Code:17847
Practice Address - Country:US
Practice Address - Phone:570-742-9516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015155510004Medicaid
PA0015155510004Medicaid
590006062Medicare PIN