Great Bend Hallstead Volunteer Ambulance Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

05007 Issued in PA

Legal business name

GREAT BEND HALLSTEAD VOLUNTEER AMBULANCE INC

Practice address

5 Carrol St
Great Bend, PA 18821-7700

Phone

(570) 879-4483

NPI assigned

Dec 28, 2005

Last updated

Dec 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anthony J Conarton

Title

President

Phone

(570) 879-2026

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1497732721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130270535",
            "telephone_number": "315-635-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CARROL ST",
            "city": "GREAT BEND",
            "state": "PA",
            "postal_code": "188217700",
            "telephone_number": "570-879-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT BEND HALLSTEAD VOLUNTEER AMBULANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "CONARTON",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-879-2026"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "05007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD",
            "identifier": "590014168",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "07600166",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00076001630003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Health Source of Great Bend Inc
• Lourdes Hospital
• Lourdes Hospital
• Brett Allen Mullen, D.C.
• Resurrection House LLC (Resurrection House)

• Ambulance in Great Bend, PA
• Providers in Great Bend, PA by specialty
• Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.