Organization Active NPI

Cranberry Township Emergency Medical Service

  • Paramedic
  • Cranberry TWP, PA
National Provider Identifier
1265417067
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ParamedicTaxonomy code 146L00000X
License
02188 Issued in PA
Legal business name
CRANBERRY TOWNSHIP EMERGENCY MEDICAL SERVICE
Practice address
802 Thomson Park Dr
Cranberry TWP, PA 16066-6428
Phone
(724) 776-4380
Fax
(724) 779-1040
NPI assigned
Dec 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Authorized official

Name
Mr. Scott J Smith
Title
President
Phone
(724) 776-4380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ParamedicGroup: 193400000X SINGLE SPECIALTY GROUP 146L00000X 02188 PA Primary

Addresses

Primary practice location

802 Thomson Park Dr
Cranberry TWP, PA 16066-6428

Mailing address

802 Thomson Park Dr
Cranberry TWP, PA 16066-6428
Phone (724) 776-4380

Other identifiers 1

IdentifierTypeStateIssuer
0010590300001MedicaidPA

Other names 1

  • Cranberry Volunteer Ambulance Corps Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041206000692 PA Part B Supplier - Ambulance Service Supplier 3779549373 Practice locations: Cranberry Township, PA

National Provider Directory

National Provider Directory

Locations

802 Thomson Park Dr
Cranberry Twp, PA 16066
Phone (724) 776-4380

20727 Route 19
#51
Cranberry Twp, PA 16066
Phone (724) 776-4380

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1265417067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 THOMSON PARK DR",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666428",
            "telephone_number": "724-776-4380",
            "fax_number": "724-779-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 THOMSON PARK DR",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666428",
            "telephone_number": "724-776-4380",
            "fax_number": "724-779-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANBERRY TOWNSHIP EMERGENCY MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-776-4380",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "PA",
            "license": "02188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010590300001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cranberry Volunteer Ambulance Corps",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cranberry TWP, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.