Provider Demographics
NPI:1740234871
Name:SOUTHERN BERKS REGIONAL EMERGENCY MEDICAL SERVICES
Entity Type:Organization
Organization Name:SOUTHERN BERKS REGIONAL EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:R
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-724-4141
Mailing Address - Street 1:769 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-9307
Mailing Address - Country:US
Mailing Address - Phone:610-775-1041
Mailing Address - Fax:
Practice Address - Street 1:769 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-9307
Practice Address - Country:US
Practice Address - Phone:610-775-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA020373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA22965OtherHEALTH PARTNERS
PA50003023OtherCAPITAL BLUE CROSS
PA1503666OtherGATEWAY HEALTH PLAN
PA201121OtherHIGHMARK
PA33074OtherHEALTHAMERICA
PA0020632000OtherINDEPENDENCE BLUE CROSS
PA001194034Medicaid
PW1001182OtherAMERIHEALTH MERCY
PA125044OtherUNISON HEALTH PLAN
PA125044OtherUNISON HEALTH PLAN
PA201121Medicare ID - Type UnspecifiedMEDICARE