Provider Demographics
NPI:1861481269
Name:POCONO MOUNTAIN REGIONAL EMERGENCY MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:POCONO MOUNTAIN REGIONAL EMERGENCY MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOREMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-350-0029
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-0207
Mailing Address - Country:US
Mailing Address - Phone:484-664-2007
Mailing Address - Fax:484-664-2015
Practice Address - Street 1:135 TEGAWITHA RD
Practice Address - Street 2:
Practice Address - City:TOBYHANNA
Practice Address - State:PA
Practice Address - Zip Code:18466-7796
Practice Address - Country:US
Practice Address - Phone:570-839-8485
Practice Address - Fax:570-839-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
1446752OtherBC OF NE PA
359501200OtherDEPT OF LABOR WORK COMP
816393OtherFIRST PRIORITY HEALTH
PA001945900003Medicaid
20035568OtherAMERIHEALTH MERCY HMO DPA
PA0019454900001Medicaid
816393OtherBCNE CONTRACT CLAIMS
359501200OtherDEPT OF LABOR WORK COMP
816393OtherFIRST PRIORITY HEALTH