Provider Demographics
NPI:1922146554
Name:HARLEYSVILLE AREA EMERGENCY MEDICAL SERVICE, INC.
Entity Type:Organization
Organization Name:HARLEYSVILLE AREA EMERGENCY MEDICAL SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-513-1880
Mailing Address - Street 1:309 MAIN ST
Mailing Address - Street 2:PO BOX 16
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2418
Mailing Address - Country:US
Mailing Address - Phone:215-513-1880
Mailing Address - Fax:215-513-2003
Practice Address - Street 1:309 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2418
Practice Address - Country:US
Practice Address - Phone:717-724-4136
Practice Address - Fax:717-214-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-09-09
Deactivation Date:2020-07-15
Deactivation Code:
Reactivation Date:2020-09-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080142Medicare PIN