Provider Demographics
NPI:1912920588
Name:RYAN TOWNSHIP EMERGENCY AND RESCUE SQUAD INC
Entity Type:Organization
Organization Name:RYAN TOWNSHIP EMERGENCY AND RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-467-3424
Mailing Address - Street 1:848 BARNESVILLE DR
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18214-2017
Mailing Address - Country:US
Mailing Address - Phone:570-467-3424
Mailing Address - Fax:570-467-0447
Practice Address - Street 1:848 BARNESVILLE DR
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:PA
Practice Address - Zip Code:18214-2017
Practice Address - Country:US
Practice Address - Phone:570-467-3424
Practice Address - Fax:570-467-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA89033000OtherFEDERAL BLACK LUNG PROG
PA0011761340004Medicaid
PA207704Medicare PIN
590009375Medicare PIN