Organization
PIKE COUNTY ADVANCED LIFE SUPPORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LOU CORBETT (PRESIDENT)
(570) 828-2225
Entity
Organization
Contact information
Practice address
149 SAWKILL AVE, MILFORD, PA 18337-1141
(570) 296-2580
(570) 832-2164
Mailing address
PO BOX 384, DINGMANS FERRY, PA 18328-0384
(570) 296-2580
(570) 832-2164
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015389420002
—
PA
Enumeration date
07/24/2006
Last updated
02/07/2013
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