Provider Demographics
NPI:1679576680
Name:BURHOLME FIRST AID CORPS, INC.
Entity Type:Organization
Organization Name:BURHOLME FIRST AID CORPS, INC.
Other - Org Name:BURHOLME EMERGENCY MEDICAL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:H
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-725-4030
Mailing Address - Street 1:830 BLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3016
Mailing Address - Country:US
Mailing Address - Phone:215-725-4030
Mailing Address - Fax:215-745-3997
Practice Address - Street 1:830 BLEIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-3016
Practice Address - Country:US
Practice Address - Phone:215-725-4030
Practice Address - Fax:215-745-3997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033303416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001561803Medicaid
PA0000130000OtherKEYSTONE HEALTH PLAN EAST
PA0016408OtherAETNA US HEALTHCARE
PA0062672000OtherBLUE CROSS PERSONAL CHOIC
PA1005094OtherKEYSTONE MERCY
PA0062672000OtherBLUE CROSS PERSONAL CHOIC