Blacklick Valley Foundation and Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

03150 Issued in PA

Legal business name

BLACKLICK VALLEY FOUNDATION AND AMBULANCE SERVICE INC

Practice address

1077 1St St
Nanty Glo, PA 15943-1159

Phone

(814) 749-7332

Fax

(814) 749-7188

NPI assigned

Apr 17, 2006

Organization subpart

No

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

Authorized official

Name

Beverly Sherwood-Burns

Title

President

Phone

(814) 749-7332

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Marie Buck

  • Basic Emergency Medical Technician
  • Nanty Glo, PA
  • NPI 1477209286
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1033173828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 1ST ST",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159431159",
            "telephone_number": "814-749-7332",
            "fax_number": "814-749-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 1ST ST",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159431159",
            "telephone_number": "814-749-7332",
            "fax_number": "814-749-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKLICK VALLEY FOUNDATION AND AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "SHERWOOD-BURNS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-749-7332"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "03150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008930680001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "281902",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590001284",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alternative Community Resource Program, Inc.
• Alternative Community Resource Program, Inc.
• Megan Joy Beiler, LSW
• Blacklick Valley School District
• Susan Marie Buck
• Conemaugh Health Initiatives
• Conemaugh Health Initiatives
• Conemaugh Health Initiatives

• Land Ambulance in Nanty Glo, PA
• Providers in Nanty Glo, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.