Organization
DICKSON CITY COMMUNITY AMBULANCE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS R. HOMENCHAK (TREASURER/SUPERVISOR)
(570) 383-1399
Entity
Organization
Contact information
Practice address
2 EAGLE LN, DICKSON CITY, PA 18519-1350
(570) 383-1399
(570) 307-1005
Mailing address
2 EAGLE LN, DICKSON CITY, PA 18519-1350
(570) 383-1399
(570) 307-1005
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000424114195
HEALTH PLUS
PA
05
—
0014112520001
—
PA
01
—
0568303
AETNA
PA
01
—
PB4506
HEALTH NET
PA
Enumeration date
05/12/2006
Last updated
12/29/2014
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