Provider Demographics
NPI:1942346200
Name:MARKLEYSBURG COMM AMBULANCE
Entity Type:Organization
Organization Name:MARKLEYSBURG COMM AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMANDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:724-329-1455
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:FAIRCHANCE
Mailing Address - State:PA
Mailing Address - Zip Code:15436-0505
Mailing Address - Country:US
Mailing Address - Phone:724-564-5881
Mailing Address - Fax:724-564-1438
Practice Address - Street 1:4931 NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:MARKLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:15459-0005
Practice Address - Country:US
Practice Address - Phone:724-329-1314
Practice Address - Fax:724-329-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA341600000X, 343900000X
PA260143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012228180001Medicaid
PA0012228180001Medicaid
PA0012228180001Medicaid