Organization
BEAVERDALE AREA AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM M. EVANCKIC (PRESIDENT)
(814) 487-5407
Entity
Organization
Contact information
Practice address
618 CAMERON AVE, BOX 435, BEAVERDALE, PA 15921-0435
(814) 487-5407
(814) 487-5407
Mailing address
PO BOX 816, JOHNSTOWN, PA 15907-0816
(614) 536-9951
(814) 536-9952
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
06118
PA
3416L0300X
Land Ambulance
1100379
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000286911
HIGHMARK BLUE CROSS
PA
05
—
0007322270002
—
PA
Enumeration date
01/14/2006
Last updated
12/03/2009
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