Lake Meade Fire & Rescue Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

03130 Issued in PA

Legal business name

LAKE MEADE FIRE & RESCUE INC

Practice address

492 Lake Meade Dr
East Berlin, PA 17316-9345

Phone

(717) 259-8338

NPI assigned

Oct 12, 2005

Organization subpart

No

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

Authorized official

Name

Julie Brandt

Title

Trustee Assistant Chief

Phone

(717) 259-8338

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1083602114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181050207",
            "telephone_number": "484-664-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 LAKE MEADE DR",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173169345",
            "telephone_number": "717-259-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MEADE FIRE & RESCUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "TRUSTEE ASSISTANT CHIEF",
        "authorized_official_telephone_number": "717-259-8338"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "03130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017519150001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC BLUE BELL HMO",
            "identifier": "0899588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "284924",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in East Berlin, PA
• Providers in East Berlin, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.