Shippenville Elk Township Volunt

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

03021 Issued in PA

Legal business name

SHIPPENVILLE ELK TOWNSHIP VOLUNT

Practice address

207 Main St
Shippenville, PA 16254-3905

Phone

(814) 782-6245

Fax

(814) 782-3327

NPI assigned

Sep 23, 2005

Last updated

Mar 28, 2013By 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

Rodney Jeannerat

Title

Treasurer

Phone

(814) 782-6245

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Shippenville/Elk Volunteer Ambulance Service Other name

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1497741466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181050207",
            "telephone_number": "800-473-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MAIN ST",
            "city": "SHIPPENVILLE",
            "state": "PA",
            "postal_code": "162543905",
            "telephone_number": "814-782-6245",
            "fax_number": "814-782-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIPPENVILLE ELK TOWNSHIP VOLUNT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "JEANNERAT",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "814-782-6245"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "03021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012691900004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF PA BLUE SHIELD",
            "identifier": "282131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC RR MEDICARE",
            "identifier": "590010198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY DPA COMPUTER SCIENCES",
            "identifier": "000000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY EMPIRE MEDICARE",
            "identifier": "000000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "081243600",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shippenville/Elk Volunteer Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Derek Francis Oberlander
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• Shippenville PA Opco LLC (Shippenville Nursing and Rehab)
• Shippenville Project Point of Light, Inc Dba Manno Therapeutic Service
• Nathanial Ryan Tyger, LPC
• Vna Extended Care Services, Inc
• Vna Extended Care Services, Inc

• Land Ambulance in Shippenville, PA
• Providers in Shippenville, 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 28, 2013; 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.