Provider Demographics
NPI:1881023471
Name:EASTERN REGIONAL EMERGENCY MEDICAL SERVICES,LLC
Entity Type:Organization
Organization Name:EASTERN REGIONAL EMERGENCY MEDICAL SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-340-8111
Mailing Address - Street 1:863 1ST AVE UNIT B1
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1410
Mailing Address - Country:US
Mailing Address - Phone:724-340-8111
Mailing Address - Fax:724-340-8118
Practice Address - Street 1:863 1ST AVE
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014
Practice Address - Country:US
Practice Address - Phone:724-340-8111
Practice Address - Fax:724-340-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA130223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport