Organization Active NPI

Schuylkill Valley Emergency Medical Services

  • Land Ambulance
  • Leesport, PA
National Provider Identifier
1548307135
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
05063 Issued in PA
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

Updated by the provider on Nov 27, 2007

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0020636000OtherPAINDEPENDENCE BLUE CROSS
284947OtherPAHIGHMARK BLUE SHIELD
50007305OtherPACAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070413000519 PA Part B Supplier - Ambulance Service Supplier 1951406313 Practice locations: Blandon, PA; Leesport, PA

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.