Archbald Community Ambulance and Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

04151 Issued in PA

Legal business name

ARCHBALD COMMUNITY AMBULANCE AND RESCUE SQUAD

Practice address

195 Delaware St
Archbald, PA 18403-1903

Phone

(570) 282-5652

Fax

(570) 282-5653

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Trently

Title

Secretary

Phone

(570) 282-5652

Specialties & licenses 1

Addresses

Other identifiers 8

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1356448765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "ARCHBALD",
            "state": "PA",
            "postal_code": "184030001",
            "telephone_number": "570-282-5652",
            "fax_number": "570-282-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 DELAWARE ST",
            "city": "ARCHBALD",
            "state": "PA",
            "postal_code": "184031903",
            "telephone_number": "570-282-5652",
            "fax_number": "570-282-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHBALD COMMUNITY AMBULANCE AND RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "TRENTLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "570-282-5652",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011579800004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCNEPA/AC2",
            "identifier": "280295",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-THREE RIVERS",
            "identifier": "1157980",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20017052",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NEPA",
            "identifier": "998524",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "069706",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "087558800",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590008655",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Lee Albright, RPH
• Melissa Aleksak
• Taylor-Ray Beautz, CCC-SLP
• Justine Beneski, LPC, NCC
• George Peter Black, D.M.D.
• Elizabeth Brady, LCSW
• Shana Carmody, LSW

• Land Ambulance in Archbald, PA
• Providers in Archbald, 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 17, 2017; 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.