Great Valley Ambulance Squad, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

GREAT VALLEY AMBULANCE SQUAD, LLC

Practice address

5 Lehigh Ave Ste B
Jim Thorpe, PA 18229-1200

Phone

(570) 295-5386

NPI assigned

Nov 9, 2020

Last updated

Apr 11, 2025By 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

Mr. Robert Steven Hagerty, MHA

Title

Owner/Cfo

Phone

(570) 295-5386

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1700487436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LEHIGH AVE STE B",
            "city": "JIM THORPE",
            "state": "PA",
            "postal_code": "182291200",
            "telephone_number": "570-295-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LEHIGH AVE STE B",
            "city": "JIM THORPE",
            "state": "PA",
            "postal_code": "182291200",
            "telephone_number": "570-295-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT VALLEY AMBULANCE SQUAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "HAGERTY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "570-295-5386",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Fallabel, DMD
• Jennifer Lynn Gaines, DPT
• Kimberly Gauronsky
• Daryl J Gordon, CRNP
• Marla G Grafton, LCSW
• Heather Nicole Halenar, ATC
• Patrick J Hanley, DO
• Richard H Harleman, R.P.
• Ella Hasson
• Helene Katz, PHD

• Land Ambulance in Jim Thorpe, PA
• Providers in Jim Thorpe, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.