NPIMap

Organization Active NPI

Warrior Run Area Ambulance

  • Land Ambulance
  • Watsontown, PA
National Provider Identifier
1366429920
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
WARRIOR RUN AREA AMBULANCE
Practice address
1125 Main St.
Watsontown, PA 17777-1432
Phone
(570) 538-5100
Fax
(570) 538-2967
NPI assigned
Dec 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Hestia Brown
Title
Treasurer
Phone
(570) 538-5100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 04065 PA
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1125 Main St.
Watsontown, PA 17777-1432

Mailing address

PO Box 8
Watsontown, PA 17777-0008
Phone (570) 538-5100

Other identifiers 2

IdentifierTypeStateIssuer
1012877710001MedicaidPA
P00217170OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518001054 PA Part B Supplier - Ambulance Service Supplier 3971544024 Practice locations: Lewisburg, PA; Turbotville, PA; Watsontown, PA

National Provider Directory

National Provider Directory

Locations

1125 Main St
Watsontown, PA 17777
Phone (570) 538-5100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1366429920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "city": "WATSONTOWN",
            "state": "PA",
            "postal_code": "177770008",
            "telephone_number": "570-538-5100",
            "fax_number": "570-538-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MAIN ST.",
            "city": "WATSONTOWN",
            "state": "PA",
            "postal_code": "177771432",
            "telephone_number": "570-538-5100",
            "fax_number": "570-538-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARRIOR RUN AREA AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "HESTIA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "570-538-5100"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04065",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012877710001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00217170",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.