Provider Demographics
NPI:1720287527
Name:LILLY AREA AMBULANCE ASSOCIATION
Entity Type:Organization
Organization Name:LILLY AREA AMBULANCE ASSOCIATION
Other - Org Name:LILLY AREA AMBULANCE ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARLICKREED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-886-5700
Mailing Address - Street 1:421 MAIN ST
Mailing Address - Street 2:PO BOX 6
Mailing Address - City:LILLY
Mailing Address - State:PA
Mailing Address - Zip Code:15938-1143
Mailing Address - Country:US
Mailing Address - Phone:814-886-5700
Mailing Address - Fax:814-886-9353
Practice Address - Street 1:421 MAIN ST
Practice Address - Street 2:
Practice Address - City:LILLY
Practice Address - State:PA
Practice Address - Zip Code:15938-1143
Practice Address - Country:US
Practice Address - Phone:814-886-5700
Practice Address - Fax:814-886-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA031533416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012211040001Medicaid
PA0012211040001Medicaid