Organization
CHARLES J. SPELLMAN AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOMER BERLEW (PRESIDENT)
(570) 822-5587
Entity
Organization
Contact information
Practice address
14 MARION ST, LUZERNE, PA 18709-1419
(570) 822-5587
(570) 287-3384
Mailing address
14 MARION ST, LUZERNE, PA 18709-1419
(570) 822-5587
(570) 287-3384
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
04051
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014501800001
—
PA
01
—
080008300
BLACK LUNG
PA
01
—
20005603
AMERIHEALTH
PA
01
—
200510
BLUE CROSS/BLUE SHIELD
PA
01
—
30230362S
GEISINGER HEALTH PLAN
PA
01
—
568281
AETNA
PA
01
—
805657
FIRST PRIORITY
PA
01
—
84067
THREE RIVERS
PA
01
—
998506
BLUE CROSS NEPA
PA
01
—
CJ200510
MEDICARE TRAVELERS
PA
Enumeration date
11/01/2006
Last updated
04/18/2013
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