Provider Demographics
NPI:1821032061
Name:DELAWARE TOWNSHIP VOLUNTEER AMBULANCE CORP INC
Entity Type:Organization
Organization Name:DELAWARE TOWNSHIP VOLUNTEER AMBULANCE CORP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-828-2345
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-0186
Mailing Address - Country:US
Mailing Address - Phone:570-828-2345
Mailing Address - Fax:
Practice Address - Street 1:135 PARK RD
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328
Practice Address - Country:US
Practice Address - Phone:570-828-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012648900001Medicaid
590006846Medicare PIN
PA220407Medicare PIN