Provider Demographics
NPI:1649286980
Name:TAMAQUA COMMUNITY AMBULANCE ASSOCIATION INC
Entity type:Organization
Organization Name:TAMAQUA COMMUNITY AMBULANCE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-668-3342
Mailing Address - Street 1:98 N RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-1329
Mailing Address - Country:US
Mailing Address - Phone:570-668-3342
Mailing Address - Fax:570-668-3504
Practice Address - Street 1:98 N RAILROAD ST
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-1329
Practice Address - Country:US
Practice Address - Phone:570-668-3342
Practice Address - Fax:570-668-3504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50005OtherHEALTH AMERICA
PA083347400OtherFEDERAL BLACK LUNG PROG
PA0007625300004Medicaid
PA210063800OtherDEPT. OF LABOR
590009778Medicare PIN
PA285682Medicare PIN