Brockway Area Ambulance Service, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

05125 Issued in PA

Legal business name

BROCKWAY AREA AMBULANCE SERVICE, INC

Practice address

1147 Cherry St
Brockway, PA 15824-1627

Phone

(814) 265-1212

Fax

(814) 265-8898

NPI assigned

Oct 19, 2006

Last updated

Mar 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Work

Title

President of Board

Phone

(814) 265-1212

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1174605455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "city": "BROCKWAY",
            "state": "PA",
            "postal_code": "158240222",
            "telephone_number": "814-265-1212",
            "fax_number": "814-265-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 CHERRY ST",
            "city": "BROCKWAY",
            "state": "PA",
            "postal_code": "158241627",
            "telephone_number": "814-265-1212",
            "fax_number": "814-265-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKWAY AREA AMBULANCE SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "WORK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD",
        "authorized_official_telephone_number": "814-265-1212"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "05125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "044421",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590013532",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009913720001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Betton Bembenic, LSW MSW M ED
• Wendy Susan Bingler, OTR/L
• Nancy London Bittner, PT
• Jacient D. Bray, R. PH.
• Jack Britten, DMD
• Brockway Area School District
• Brockway Family Practice LLC
• Matthew T Carroll, DPT
• Clearfield-Jefferson MHMR Program
• Clearfield-Jefferson MHMR Program

• Land Ambulance in Brockway, PA
• Providers in Brockway, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.