Provider Demographics
NPI:1851390579
Name:SOUTHEASTERN ADAMS VOLUNTEER EMERGENCY SERVICES INC.
Entity Type:Organization
Organization Name:SOUTHEASTERN ADAMS VOLUNTEER EMERGENCY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WHITTAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-637-9621
Mailing Address - Street 1:PO BOX 539
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-0539
Mailing Address - Country:US
Mailing Address - Phone:717-728-1690
Mailing Address - Fax:717-728-1690
Practice Address - Street 1:5865 HANOVER RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-8966
Practice Address - Country:US
Practice Address - Phone:717-637-9621
Practice Address - Fax:717-637-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA032853416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087874Medicare PIN