Organization Active NPI

Waynesboro Ambulance Squad Inc

  • Land Ambulance
  • Waynesboro, PA
National Provider Identifier
1144212911
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
WAYNESBORO AMBULANCE SQUAD INC
Practice address
603 W Main St
Waynesboro, PA 17268-1417
Phone
(717) 762-5338
Fax
(717) 762-1735
NPI assigned
Aug 18, 2005
Last updated
Dec 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Authorized official

Name
Karen J Rock
Title
President
Phone
(717) 762-5338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

603 W Main St
Waynesboro, PA 17268-1417

Mailing address

603 W Main St
Waynesboro, PA 17268-1417
Phone (717) 762-5338

Other identifiers 5

IdentifierTypeStateIssuer
0008486250003MedicaidPA
010128889MedicaidVA
119954901OtherUS DEPT OF LABOR
3810001910MedicaidWV
401676900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090910000360 PA Part B Supplier - Ambulance Service Supplier 4981759263 Practice locations: Waynesboro, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2134878Waynesboro Ambulance Squad Inc603 West Main Street, Waynesboro, PA 17268Certificate of waiverAug 9, 2027

National Provider Directory

National Provider Directory

Locations

603 W Main St
Waynesboro, PA 17268
Phone (717) 762-5338

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1144212911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 W MAIN ST",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172681417",
            "telephone_number": "717-762-5338",
            "fax_number": "717-762-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 W MAIN ST",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172681417",
            "telephone_number": "717-762-5338",
            "fax_number": "717-762-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNESBORO AMBULANCE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "ROCK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-762-5338"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008486250003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010128889",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "119954901",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001910",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401676900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.