Organization
EXCELSIOR EMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN M HICKERNELL (MANAGING PARTNER)
(610) 757-1153
Entity
Organization
Contact information
Practice address
7 W BETHANY RD, NEWMANSTOWN, PA 17073-9191
(610) 757-1153
(610) 757-1154
Mailing address
7 W BETHANY RD, NEWMANSTOWN, PA 17073-9191
(610) 757-1153
(610) 757-1154
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026577140001
—
PA
Enumeration date
07/15/2011
Last updated
01/23/2012
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