Active NPI
Roulette Chemical Engine Co #1 Inc
- Land Ambulance
- Roulette, PA
National Provider Identifier
1033388335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- ROULETTE CHEMICAL ENGINE CO #1 INC
- Practice address
- 12 River St
Roulette, PA 16746-0172 - Phone
- (814) 544-7762
- Fax
- (814) 544-7495
- NPI assigned
- Feb 21, 2008
- Last updated
- Jul 6, 2022
- Organization subpart
- Yes
- Parent organization
- UNKNOWN
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Justin William Fillhart
- Title
- Chief
- Phone
- (610) 755-8153
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 60602 | PA | |
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
12 River St
Roulette, PA 16746-0172
Mailing address
PO Box 172
Roulette, PA 16746-0172
Phone (814) 544-7762
Other names 1
- Roulette Ambulance
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040121000264 | PA | Part B Supplier - Ambulance Service Supplier | 4981506011 | Practice locations: Roulette, PA |
National Provider Directory
National Provider Directory- Part of
- Roulette Chemical Eng Co
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657065600000",
"number": "1033388335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 172",
"city": "ROULETTE",
"state": "PA",
"postal_code": "167460172",
"telephone_number": "814-544-7762",
"fax_number": "814-544-7495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 RIVER ST",
"city": "ROULETTE",
"state": "PA",
"postal_code": "167460172",
"telephone_number": "814-544-7762",
"fax_number": "814-544-7495"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROULETTE CHEMICAL ENGINE CO #1 INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "UNKNOWN",
"enumeration_date": "2008-02-21",
"last_updated": "2022-07-06",
"certification_date": "2022-07-06",
"status": "A",
"authorized_official_last_name": "FILLHART",
"authorized_official_first_name": "JUSTIN",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "CHIEF",
"authorized_official_telephone_number": "610-755-8153"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PA",
"license": "60602",
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Roulette Ambulance",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Roulette Ambulance",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Roulette, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.