Provider Demographics
NPI:1609853779
Name:COMMUNITY AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:COMMUNITY AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-437-3016
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-0909
Mailing Address - Country:US
Mailing Address - Phone:814-437-3016
Mailing Address - Fax:814-432-4778
Practice Address - Street 1:1010 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-1208
Practice Address - Country:US
Practice Address - Phone:814-437-3016
Practice Address - Fax:814-432-4778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03097341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007602590002Medicaid
PA0007602590002Medicaid