Jackson Township Volunteer Ambulance Association

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

JACKSON TOWNSHIP VOLUNTEER AMBULANCE ASSOCIATION

Practice address

1160 Chase Rd
Shavertown, PA 18708-9504

Phone

(570) 696-4544

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Brian L Titus

Title

President

Phone

(570) 696-4544

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1477598092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 582",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186120582",
            "telephone_number": "570-696-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 CHASE RD",
            "city": "SHAVERTOWN",
            "state": "PA",
            "postal_code": "187089504",
            "telephone_number": "570-696-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON TOWNSHIP VOLUNTEER AMBULANCE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "TITUS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-696-4544"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012771640001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Hammerman, MD
• Helix Council
• Deborah Clairmont Howe, PT
• Stephen Hurwitz, OD
• Michelle Jeena Im, DO
• Thomas Paul Jiunta, DPM MA
• Jream Team LLC
• Kingston Township Ambulance and Rescue Association
• Albert R Klein Jr., DC
• Roberta Klein, LDN, D.C.

• All providers in Shavertown, PA
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.