Organization
WEST END ADVANCED LIFE SUPPORT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE WENZEL (OFFICE MANAGER)
(610) 681-5810
Entity
Organization
Contact information
Practice address
296 OLD ROUTE 115, SAYLORSBURG, PA 18353
(610) 681-5810
(610) 681-5643
Mailing address
PO BOX 296, SAYLORSBURG, PA 18353-0296
(610) 681-5810
(610) 681-5643
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04194
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017216760001
—
PA
Enumeration date
06/28/2005
Last updated
05/19/2008
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