Organization
CONESTOGA AMBULANCE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL C ROTH (BILLING)
(717) 464-0724
Entity
Organization
Contact information
Practice address
3292 MAIN ST, CONESTOGA, PA 17516-9702
(717) 464-0724
Mailing address
PO BOX 329, WILLOW STREET, PA 17584-0329
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04241
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009418900007
—
PA
Enumeration date
11/30/2005
Last updated
08/22/2020
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