Organization
CITY OF BRADFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERI CANNON (CITY ADMINISTRATOR)
(814) 362-3887
Entity
Organization
Contact information
Practice address
24 KENNEDY ST, BRADFORD, PA 16701-6508
(814) 362-3887
(814) 368-3335
Mailing address
24 KENNEDY ST, BRADFORD, PA 16701-2006
(814) 362-3887
(814) 368-3335
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04055
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001085817
—
PA
05
—
01404324
—
NY
01
—
590004092
AMBULANCE SERVICE
PA
Enumeration date
12/12/2005
Last updated
03/04/2015
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