Organization
OLD FORGE AMBULANCE & RESCUE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GOTAY (TREASURER)
(570) 457-9693
Entity
Organization
Contact information
Practice address
239 RAILROAD ST, OLD FORGE, PA 18518-2003
(570) 457-9693
(570) 504-8343
Mailing address
PO BOX 207, ALLENTOWN, PA 18105-0207
(484) 664-2007
(484) 664-2015
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
05134
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012373830004
—
PA
01
—
590007073
RAILROAD MEDICARE
PA
01
—
801316
FEDERAL BLACK LUNG
PA
Enumeration date
05/17/2007
Last updated
12/23/2014
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