Utica Volunteer Fire Co & Relief Association
Organization Active NPI Land Ambulance · Utica, PA
NPI 1366480444 · NPPES record last updated May 24, 2023
Key facts
- NPI
- 1366480444
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 03350 (PA)
- Legal business name
- UTICA VOLUNTEER FIRE CO & RELIEF ASSOCIATION
- Practice address
- 3860 Academy St
Utica, PA 16362-0083 - Phone
- (814) 573-1980
- Fax
- (814) 425-1735
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Homer Hollabaugh
- Title
- Captain
- Phone
- (814) 573-1980
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041216000531 | PA | Part B Supplier - Ambulance Service Supplier | 6002873528 | Practice locations: Utica, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 03350 | PA | Yes |
Addresses
Primary practice location
3860 Academy St
Utica, PA 16362-0083
Mailing address
409 Porter Ave
Scottdale, PA 15683-1141
Phone (724) 887-6822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009139010004 | Medicaid | PA |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.