White Haven Rescue Unit, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

05049 Issued in PA

Legal business name

WHITE HAVEN RESCUE UNIT, INC.

Practice address

500 Towanda St # 502
White Haven, PA 18661-1519

Phone

(570) 443-9499

Fax

(570) 443-0666

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

George D Wood

Title

Vice President

Phone

(570) 443-9499

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737244800000",
    "number": "1104042019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TOWANDA ST",
            "city": "WHITE HAVEN",
            "state": "PA",
            "postal_code": "186611519",
            "telephone_number": "570-443-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TOWANDA ST # 502",
            "city": "WHITE HAVEN",
            "state": "PA",
            "postal_code": "186611519",
            "telephone_number": "570-443-9499",
            "fax_number": "570-443-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE HAVEN RESCUE UNIT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "570-443-9499"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "05049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011031380002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "060409",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590008841",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "800423",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asmita C Shah, M.D.
• Solacium Holdings, LLC
• Anthony Paul Aquino Villafuerte
• Zenia Gimenez Villafuerte, PT
• White Haven Center

• Land Ambulance in White Haven, PA
• Providers in White Haven, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.