Provider Demographics
NPI:1770827925
Name:LIBERTY EMS
Entity Type:Organization
Organization Name:LIBERTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:SENKBEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-789-7442
Mailing Address - Street 1:614 BRIDGETON RD
Mailing Address - Street 2:
Mailing Address - City:FAWN GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17321-9350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:614 BRIDGETON RD
Practice Address - Street 2:
Practice Address - City:FAWN GROVE
Practice Address - State:PA
Practice Address - Zip Code:17321-9350
Practice Address - Country:US
Practice Address - Phone:443-536-4077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-11
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)