Provider Demographics
NPI:1013937465
Name:AVOCA AMBULANCE ASSOCIATION INC.
Entity Type:Organization
Organization Name:AVOCA AMBULANCE ASSOCIATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEHOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-718-6980
Mailing Address - Street 1:PO BOX 1830
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-0830
Mailing Address - Country:US
Mailing Address - Phone:570-718-6980
Mailing Address - Fax:570-718-6983
Practice Address - Street 1:740 MAIN ST
Practice Address - Street 2:
Practice Address - City:AVOCA
Practice Address - State:PA
Practice Address - Zip Code:18641-1623
Practice Address - Country:US
Practice Address - Phone:570-457-1245
Practice Address - Fax:570-451-2906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04267341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009507810004Medicaid
PA998543OtherBC OF NEPA MAJOR MEDICAL
PA080628OtherFIRST PRIORITY HEALTH
PA998543OtherBC OF NEPA MAJOR MEDICAL