Organization
JACKSON TOWNSHIP VOLUNTEER AMBULANCE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN L TITUS (PRESIDENT)
(570) 696-4544
Entity
Organization
Contact information
Practice address
1160 CHASE RD, SHAVERTOWN, PA 18708-9504
(570) 696-4544
Mailing address
PO BOX 582, DALLAS, PA 18612-0582
(570) 696-4544
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012771640001
—
PA
Enumeration date
06/18/2006
Last updated
05/22/2008
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