Organization
CONNEAUT LAKE AREA AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADEIRA T. PARASKOS (CEO)
(814) 382-1133
Entity
Organization
Contact information
Practice address
290 S 4TH ST EXTENSION, CONNEAUT LAKE, PA 16316
(814) 382-1133
(814) 382-9285
Mailing address
PO BOX 546, CONNEAUT LAKE, PA 16316-0546
(814) 382-1133
(814) 382-9285
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009844110002
—
PA
01
—
280240
BLUE CROSS BLUE SHIELD
PA
Enumeration date
01/26/2006
Last updated
04/24/2008
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