Organization
COMMUNITY AMBULANCE SERVICE CLUB
Active
Other names
Tower Porter Community Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMIAH A DEITER (PRESIDENT)
(717) 943-8013
Entity
Organization
Contact information
Practice address
633 EAST COLLIERY AVENUE, TOWER CITY, PA 17980
(717) 943-8013
(717) 647-2546
Mailing address
PO BOX 33, TOWER CITY, PA 17980-0033
(717) 647-2271
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04141
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012143980004
—
PA
01
—
0130130
THREE RIVERS
PA
01
—
20018661
AMERIHEALTH MERCY
PA
01
—
50004678
CAPITAL BLUE CROSS
PA
01
—
590007322
RR MEDICARE
PA
01
—
893120
BLACK LUNG PROGRAM
PA
Enumeration date
02/26/2007
Last updated
09/15/2015
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