Excelsior EMS LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

EXCELSIOR EMS LLC

Practice address

7 W Bethany Rd
Newmanstown, PA 17073-9191

Phone

(610) 757-1153

Fax

(610) 757-1154

NPI assigned

Jul 15, 2011

Last updated

Jan 23, 2012By 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

Shawn M Hickernell

Title

Managing Partner

Phone

(610) 757-1153

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1588952246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W BETHANY RD",
            "city": "NEWMANSTOWN",
            "state": "PA",
            "postal_code": "170739191",
            "telephone_number": "610-757-1153",
            "fax_number": "610-757-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W BETHANY RD",
            "city": "NEWMANSTOWN",
            "state": "PA",
            "postal_code": "170739191",
            "telephone_number": "610-757-1153",
            "fax_number": "610-757-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-15",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "HICKERNELL",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "610-757-1153"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026577140001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Achey, MS, RD
• Mark P Gibble, PTA
• Heritage Family Health, PC
• Christopher Russell Johnson, OTR/L, MS
• Erin Murphy-Yoder
• Newmanstown Volunteer Fire Company

• Land Ambulance in Newmanstown, PA
• Providers in Newmanstown, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.