Organization
LACKAWANNA AMBULANCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD SEAN BUCKMAN (PRESIDENT CEO)
(570) 207-5200
Entity
Organization
Contact information
Practice address
1000 REMINGTON AVE, SCRANTON, PA 18505-1118
(570) 207-5200
(570) 207-5266
Mailing address
1000 REMINGTON AVE, SCRANTON, PA 18505-1118
(570) 207-5200
(570) 207-5266
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
04164
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000096978
THREE RIVERS HLTH PLN
PA
01
—
0077296000
INDEPENDENCE BC ID
PA
05
—
02635725
—
NY
01
—
080017000
FEDERAL BLACK LUNG ID
PA
05
—
1007506200003
—
PA
01
—
1539617
GATEWAY
PA
01
—
206068
FEDERAL BCBS ID
PA
01
—
35511
HEALTH PARTNERS ID
PA
01
—
359796600
OWCP ID
PA
05
—
4076133 00
—
MD
01
—
807228
FIRST PRIORITY
PA
01
—
998575
BLUE CROSS NEPA
PA
Enumeration date
09/22/2006
Last updated
09/29/2010
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