Organization
JIM THORPE EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS G LAGER (PRESIDENT)
(570) 325-4806
Entity
Organization
Contact information
Practice address
100 E 10TH ST, JIM THORPE, PA 18229
(570) 325-4806
Mailing address
PO BOX 4096, JIM THORPE, PA 18229-4096
(570) 325-4806
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
05179
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016621630005
—
PA
01
—
35946
HEALTH PARTNERS
PA
01
—
3777775
AETNA
PA
Enumeration date
07/20/2006
Last updated
08/22/2020
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