Altoona Logan TWP Mobile Med Emerg Dept Authority

Primary specialty

AmbulanceTaxonomy code 341600000X

License

06065 Issued in PA

Legal business name

ALTOONA LOGAN TWP MOBILE MED EMERG DEPT AUTHORITY

Doing business as

Amed

Practice address

106 Reimer St
Altoona, PA 16602-5936

Phone

(814) 943-8993

Fax

(814) 943-7199

NPI assigned

Sep 14, 2005

Last updated

Jan 22, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary J Watters

Title

Executive Director

Phone

(814) 943-8993

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• AMED Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1023003241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1951",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166031951",
            "telephone_number": "814-943-8993",
            "fax_number": "814-943-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 REIMER ST",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166025936",
            "telephone_number": "814-943-8993",
            "fax_number": "814-943-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTOONA LOGAN TWP MOBILE MED EMERG DEPT AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "WATTERS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "814-943-8993"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "06065",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014766780003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMED",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulance in Altoona, PA
• Providers in Altoona, PA by specialty
• Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.