Organization Active NPI

Pittston Township Ambulance Association

  • Land Ambulance
  • Pittston, PA
National Provider Identifier
1235298167
Registry record updated Aug 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
PITTSTON TOWNSHIP AMBULANCE ASSOCIATION
Practice address
24 Bryden St
Pittston, PA 18640-3449
Phone
(570) 654-4717
NPI assigned
Dec 6, 2006
Last updated
Aug 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2024

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

Authorized official

Name
Mr. Donald D Hudzinski Sr.
Title
President
Phone
(570) 654-4717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X NU Primary

Addresses

Primary practice location

24 Bryden St
Pittston, PA 18640-3449

Mailing address

24 Bryden St
Pittston, PA 18640-3449
Phone (570) 654-4717

Other identifiers 2

IdentifierTypeStateIssuer
801322OtherFEDERAL BLACK LUNG
0012514080006MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100909000391 PA Part B Supplier - Ambulance Service Supplier 6608991062 Practice locations: Pittston TWP, 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
39D2164655Pittston Township Ambulance24 Bryden Street, Pittston Township, PA 18640Certificate of waiverApr 10, 2027

National Provider Directory

National Provider Directory

Locations

24 Bryden St
Pittston Twp, PA 18640
Phone (570) 654-4717

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723939200000",
    "number": "1235298167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 BRYDEN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186403449",
            "telephone_number": "570-654-4717",
            "fax_number": "570-602-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 BRYDEN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186403449",
            "telephone_number": "570-654-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITTSTON TOWNSHIP AMBULANCE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A",
        "authorized_official_last_name": "HUDZINSKI",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-654-4717",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "801322",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012514080006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; 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.