Provider Demographics
NPI:1841224037
Name:BERWICK AREA AMBULANCE ASSOCIATION, INC.
Entity Type:Organization
Organization Name:BERWICK AREA AMBULANCE ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:C
Authorized Official - Last Name:VENDITTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-752-5321
Mailing Address - Street 1:2018 N VINE ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-1349
Mailing Address - Country:US
Mailing Address - Phone:570-752-5321
Mailing Address - Fax:
Practice Address - Street 1:2018 N VINE ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-1349
Practice Address - Country:US
Practice Address - Phone:570-752-5321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA052313416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015340470002Medicaid
PA280729OtherHIGHMARK BLUE SHIELD
PA335158OtherHEALTH ASSURANCE
PAP025003OtherTRICARE CHAMPUS
PA083417400OtherFEDERAL BLACK LUNG PROGRA
PA156906OtherPREFERRED CARE
PA20019923OtherAMERIHEALTH MERCY
PA280729Medicare PIN
PA335158OtherHEALTH ASSURANCE