Active NPI
Canonsburg General Hospital Ambulance Service
- Land Ambulance
- Canonsburg, PA
National Provider Identifier
1598744435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 04005
- Legal business name
- CANONSBURG GENERAL HOSPITAL AMBULANCE SERVICE
- Practice address
- 209 W Pike St
Canonsburg, PA 15317-1143 - Phone
- (724) 745-6911
- Fax
- (724) 745-8919
- NPI assigned
- Jan 10, 2006
- 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. Terry M Wiltrout
- Title
- Director of Operations
- Phone
- (724) 873-5880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 04005 | PA | Primary |
Addresses
Primary practice location
209 W Pike St
Canonsburg, PA 15317-1143
Mailing address
PO Box 207
Allentown, PA 18105-0207
Phone (484) 664-2007
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1502794 | Other | GATEWAY HLTH PLAN HMO DPA | |
| 241796 | Other | PA | BCBS OF PA BLUE SHIELD |
| 103520 | Other | UPMC HEALTH PLAM COMM | |
| 590012280 | Other | UNITED HC RR MEDICARE | |
| 1004559 | Other | AETNA USHC BLUE BELL HMO | |
| 0016844380002 | Medicaid | PA | |
| 1529544 | Other | UMWA HEALTH RETIREMENT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130225000126 | PA | Part B Supplier - Ambulance Service Supplier | 3779738711 | Practice locations: Canonsburg, PA |
National Provider Directory
National Provider DirectoryLocations
209 W Pike St
Canonsburg, PA 15317
Phone (724) 745-6911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1321574400000",
"number": "1598744435",
"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": "484-664-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 W PIKE ST",
"city": "CANONSBURG",
"state": "PA",
"postal_code": "153171143",
"telephone_number": "724-745-6911",
"fax_number": "724-745-8919"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CANONSBURG GENERAL HOSPITAL AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-10",
"last_updated": "2011-11-18",
"status": "A",
"authorized_official_last_name": "WILTROUT",
"authorized_official_first_name": "TERRY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "724-873-5880",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PA",
"license": "04005",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HLTH PLAN HMO DPA",
"identifier": "1502794",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF PA BLUE SHIELD",
"identifier": "241796",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC HEALTH PLAM COMM",
"identifier": "103520",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HC RR MEDICARE",
"identifier": "590012280",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA USHC BLUE BELL HMO",
"identifier": "1004559",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016844380002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA HEALTH RETIREMENT",
"identifier": "1529544",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Canonsburg, PA
- Canonsburg General Hospital
- Canonsburg General Hospital
- Canonsburg General Hospital (Canonsburg General Hospital-Rehab)
- Canonsburg General Hospital
- Canonsburg General Hospital - Spu
- Canonsburg Podiatry Associates
- Alyssa Capatolla, NP
- Marybeth Caputo, RD LDN CDCES
- Shelley D'Orazio Carbaugh, M.A., LPC
- Caregivers on Demand LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.