Active NPI
Schuylkill Valley Emergency Medical Services
- Land Ambulance
- Leesport, PA
National Provider Identifier
1548307135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 05063
- Legal business name
- SCHUYLKILL VALLEY EMERGENCY MEDICAL SERVICES
- Practice address
- 26 E. Wall Street
Leesport, PA 19533-0490 - Phone
- (610) 926-3858
- Fax
- (610) 926-9585
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Stephen Bobella
- Title
- Executive Chief
- Phone
- (610) 926-3858
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 05063 | PA | Primary |
Addresses
Primary practice location
26 E. Wall Street
Leesport, PA 19533-0490
Mailing address
PO Box 490
Leesport, PA 19533-0490
Phone (610) 926-3858
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0020636000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 284947 | Other | PA | HIGHMARK BLUE SHIELD |
| 50007305 | Other | PA | CAPITAL BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070413000519 | PA | Part B Supplier - Ambulance Service Supplier | 1951406313 | Practice locations: Blandon, PA; Leesport, PA |
National Provider Directory
National Provider DirectoryLocations
26 E Wall St
Leesport, PA 19533
Phone (610) 820-9420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1196121600000",
"number": "1548307135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 490",
"city": "LEESPORT",
"state": "PA",
"postal_code": "195330490",
"telephone_number": "610-926-3858",
"fax_number": "610-926-9585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 E. WALL STREET",
"city": "LEESPORT",
"state": "PA",
"postal_code": "195330490",
"telephone_number": "610-926-3858",
"fax_number": "610-926-9585"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCHUYLKILL VALLEY EMERGENCY MEDICAL SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-31",
"last_updated": "2007-11-27",
"status": "A",
"authorized_official_last_name": "BOBELLA",
"authorized_official_first_name": "STEPHEN",
"authorized_official_title_or_position": "EXECUTIVE CHIEF",
"authorized_official_telephone_number": "610-926-3858",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PA",
"license": "05063",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "0020636000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "284947",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50007305",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Leesport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.