Provider Demographics
NPI:1891755070
Name:CITY OF BETHLEHEM
Entity Type:Organization
Organization Name:CITY OF BETHLEHEM
Other - Org Name:CITY OF BETHLEHEM EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF EMS
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:F
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:610-865-7111
Mailing Address - Street 1:540 STEFKO BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7052
Mailing Address - Country:US
Mailing Address - Phone:610-865-7111
Mailing Address - Fax:610-865-7292
Practice Address - Street 1:540 STEFKO BLVD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7052
Practice Address - Country:US
Practice Address - Phone:610-865-7111
Practice Address - Fax:610-865-7292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA030493416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA285561Medicare ID - Type Unspecified