Duryea Ambulance and Rescue Service Assoc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

05158 Issued in PA

Legal business name

DURYEA AMBULANCE AND RESCUE SERVICE ASSOC

Practice address

261 Marcy St
Duryea, PA 18642-1352

Phone

(570) 451-0404

Fax

(570) 451-1210

NPI assigned

Nov 22, 2006

Last updated

Jun 30, 2009By 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

Frank Bodosky

Title

Captain

Phone

(570) 237-7348

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1033284245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1846",
            "city": "SHAVERTOWN",
            "state": "PA",
            "postal_code": "187080846",
            "telephone_number": "570-714-3694",
            "fax_number": "570-714-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MARCY ST",
            "city": "DURYEA",
            "state": "PA",
            "postal_code": "186421352",
            "telephone_number": "570-451-0404",
            "fax_number": "570-451-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURYEA AMBULANCE AND RESCUE SERVICE ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "BODOSKY",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "570-237-7348"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "05158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014387570003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Duryea, PA
• Providers in Duryea, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.