Madera Volunteer Ambulance Service

Organization Active NPI Land Ambulance · Madera, PA

NPI 1306845136 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1306845136
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
License
05047 (PA)
Legal business name
MADERA VOLUNTEER AMBULANCE SERVICE
Practice address
Rte 53 Main St
Madera, PA 16661
Phone
(814) 378-8777
Fax
(814) 378-5797
NPI assigned
Jul 14, 2005
Organization subpart
No

Authorized official

Name
Faye Willey
Title
Treasurer/Secretary
Phone
(814) 378-8777

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20111018000056 PA Part B Supplier - Ambulance Service Supplier 2163694142 Practice locations: Madera, PA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 05047 PA Yes

Addresses

Primary practice location

Rte 53 Main St
Madera, PA 16661

Mailing address

PO Box 726
New Cumberland, PA 17070-0726
Phone (717) 214-6018

Other providers in Madera, PA

All providers in Madera, PA · Land Ambulance in Pennsylvania

Sources for this page

Verify at the official NPI Registry.