Provider Demographics
NPI:1629121355
Name:RICHFIELD AMBULANCE LEAGUE INC
Entity Type:Organization
Organization Name:RICHFIELD AMBULANCE LEAGUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNSBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-539-4075
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17086-0236
Mailing Address - Country:US
Mailing Address - Phone:717-694-3711
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 35 WEST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:PA
Practice Address - Zip Code:17086
Practice Address - Country:US
Practice Address - Phone:717-694-3711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04042146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011135280002Medicaid
PA0011135280002Medicaid