Organization
PLYMOUTH BOROUGH AMBULANCE ASSOC. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT MILLER (PRESIDENT)
(570) 779-4388
Entity
Organization
Contact information
Practice address
24 GAYLORD AVE, PLYMOUTH, PA 18651-2202
(570) 779-9878
(570) 779-4666
Mailing address
24 GAYLORD AVE, PLYMOUTH, PA 18651-2202
(570) 779-9878
(570) 779-4666
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
04175
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019186260001
—
PA
01
—
080026400
FEDERAL BLACK LUNG
PA
01
—
201756
BC BS OF PA BLUE SHIELD
PA
01
—
2165244
AETNA USHC BLUE BELL HMO
PA
01
—
30013904
KEYSTONE MERCY HMO DPA
PA
01
—
590014556
UNITED HC RR MEDICARE
PA
01
—
808300
FIRST PRIORITY HEALTH
PA
01
—
PA7879
PHS HEALTH PLAN COMMERCIA
PA
Enumeration date
01/11/2007
Last updated
11/09/2011
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