Organization
FIREMENS AMBULANCE SERVICE TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY R RISLEY (CHAIRMAN OF THE BOARD)
(570) 923-1446
Entity
Organization
Contact information
Practice address
800 HURON AVE, RENOVO, PA 17764-1140
(570) 923-1446
(570) 923-1446
Mailing address
800 HURON AVE, RENOVO, PA 17764-1140
(570) 923-1446
(570) 923-1446
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021945500001
—
PA
Enumeration date
05/23/2008
Last updated
02/18/2013
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