Provider Demographics
NPI:1831188994
Name:WILLIAMS TWSP EMS
Entity type:Organization
Organization Name:WILLIAMS TWSP EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-258-2866
Mailing Address - Street 1:908 PACKER ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-7360
Mailing Address - Country:US
Mailing Address - Phone:610-258-2866
Mailing Address - Fax:610-258-1153
Practice Address - Street 1:110 RAUBSVILLE RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-9746
Practice Address - Country:US
Practice Address - Phone:610-253-2204
Practice Address - Fax:610-253-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA032043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010817290004Medicaid
PA0010817290004Medicaid