B.L. Gustafson, LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

04097 Issued in PA

Legal business name

B.L. GUSTAFSON, LLC

Doing business as

Priority Care Ambulance

Practice address

18 E Willow St
Smethport, PA 16749-1508

Phone

(814) 887-1982

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Brian Gustafson

Title

Director

Phone

(814) 887-1982

Specialties & licenses 1

Addresses

Other names 1

• Priority Care Ambulance Doing business as

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": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1336204577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167490344",
            "telephone_number": "814-887-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 E WILLOW ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491508",
            "telephone_number": "814-887-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B.L. GUSTAFSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "814-887-1982"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "04097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Priority Care Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Priority Care Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulance in Smethport, PA
• Providers in Smethport, PA by specialty
• Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.