Organization
BROCKWAY AREA AMBULANCE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WORK (PRESIDENT OF BOARD)
(814) 265-1212
Entity
Organization
Contact information
Practice address
1147 CHERRY ST, BROCKWAY, PA 15824-1627
(814) 265-1212
(814) 265-8898
Mailing address
PO BOX 222, BROCKWAY, PA 15824-0222
(814) 265-1212
(814) 265-8898
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
05125
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009913720001
—
PA
01
—
044421
UMWA
PA
01
—
590013532
RAILROAD MEDICARE
PA
Enumeration date
10/19/2006
Last updated
03/18/2016
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