Provider Demographics
NPI:1295736197
Name:BUTLER AMBULANCE SERVICE CO
Entity type:Organization
Organization Name:BUTLER AMBULANCE SERVICE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:BACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-282-9595
Mailing Address - Street 1:106 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4719
Mailing Address - Country:US
Mailing Address - Phone:724-282-9595
Mailing Address - Fax:724-285-8363
Practice Address - Street 1:106 1ST ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4719
Practice Address - Country:US
Practice Address - Phone:724-282-9595
Practice Address - Fax:724-285-8363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03045341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007036370001Medicaid
PA119743500OtherDEPARTMENT OF LABOR ACS
PA0088668OtherUMULA
80485OtherUS HEALTHCARE AETNA
P019290OtherTRICARE
PA285838OtherBLUE CROSS
5901305-80OtherRR MEDICARE
080121800OtherFEDERAL BLACK LUNG
PA1013548OtherGATEWAY
5901305-80OtherRR MEDICARE