Organization Active NPI

Penn Mahoning Ambulance Association

  • Land Ambulance
  • New Ringgold, PA
National Provider Identifier
1063452324
Registry record updated Jan 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
PENN MAHONING AMBULANCE ASSOCIATION
Practice address
1748 West Penn Pike
New Ringgold, PA 17960-9401
Phone
(570) 386-2233
Fax
(570) 386-4128
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2024

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

Authorized official

Name
Valerie Coombe, EMT/BNPI 1386889376
Title
President
Phone
(570) 386-2233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1748 West Penn Pike
New Ringgold, PA 17960-9401

Mailing address

P.O.Box 135
Andreas, PA 18211-0135
Phone (570) 386-2233

Other identifiers 1

IdentifierTypeStateIssuer
001160546 0001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090702000358 PA Part B Supplier - Ambulance Service Supplier 4880745850 Practice locations: New Ringgold, PA

National Provider Directory

National Provider Directory

Locations

1748 W Penn Pike
New Ringgold, PA 17960
Phone (570) 386-2233

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705708800000",
    "number": "1063452324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 135",
            "city": "ANDREAS",
            "state": "PA",
            "postal_code": "182110135",
            "telephone_number": "570-386-2233",
            "fax_number": "570-386-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 WEST PENN PIKE",
            "city": "NEW RINGGOLD",
            "state": "PA",
            "postal_code": "179609401",
            "telephone_number": "570-386-2233",
            "fax_number": "570-386-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN MAHONING AMBULANCE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-01-20",
        "certification_date": "2024-01-20",
        "status": "A",
        "authorized_official_last_name": "COOMBE",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-386-2233",
        "authorized_official_credential": "EMT/B"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001160546 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Ringgold, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.