Organization
PENNS CREEK AMBULANCE CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY RICHARD (PRESIDENT)
(570) 837-3407
Entity
Organization
Contact information
Practice address
704 TROXELVILLE RD, PENNS CREEK, PA 17862
(570) 837-3407
Mailing address
PO BOX 125, PENNS CREEK, PA 17862-0125
(570) 837-1943
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012246700001
—
PA
Enumeration date
12/27/2005
Last updated
09/24/2008
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