Provider Demographics
NPI:1881936664
Name:TRI TOWN AMBULANCE ASSOCIATION
Entity type:Organization
Organization Name:TRI TOWN AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-848-9905
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:PA
Mailing Address - Zip Code:16948-0247
Mailing Address - Country:US
Mailing Address - Phone:814-848-7611
Mailing Address - Fax:814-848-9642
Practice Address - Street 1:810 STATE ROUTE 49 W
Practice Address - Street 2:
Practice Address - City:ULYSSES
Practice Address - State:PA
Practice Address - Zip Code:16948-9422
Practice Address - Country:US
Practice Address - Phone:814-848-7611
Practice Address - Fax:814-848-9642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028525950001Medicaid
PA270060Medicare PIN