Northern Valley Emergency Medical Services Inc
Organization Active NPI Land Ambulance · Coplay, PA
NPI 1720063860 · NPPES record last updated Mar 4, 2016
Key facts
- NPI
- 1720063860
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- NORTHERN VALLEY EMERGENCY MEDICAL SERVICES INC
- Practice address
- 2375 Levans Rd
Coplay, PA 18037-2202 - Phone
- (610) 262-1075
- Fax
- (610) 262-8630
- NPI assigned
- Dec 13, 2005
- Organization subpart
- No
Authorized official
- Name
- Lisa L Breneiser
- Title
- Office Manager
- Phone
- (610) 262-1075
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2135145 | Northern Valley Emergency Medical Services, Inc | Certificate of waiver | Aug 15, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121204000125 | PA | Part B Supplier - Ambulance Service Supplier | 5294987913 | Practice locations: Coplay, PA; New Tripoli, PA; Slatington, PA |
National Provider Directory
Locations
2375 Levans Rd
Coplay, PA 18037
Phone (610) 262-1075
6272A Route 309
New Tripoli, PA 18066
Phone (610) 262-1075
524 W Church St
Slatington, PA 18080
Phone (610) 226-1075
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
2375 Levans Rd
Coplay, PA 18037-2202
Mailing address
2375 Levans Rd
Coplay, PA 18037-2202
Phone (610) 262-1075
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1505976 | Other | PA | GATEWAY HEALTH PLAN |
| 0017025720001 | Medicaid | PA | |
| 1067558 | Other | PA | AMERIHEALTH CARITAS/NORTHEAST |
Other names
- Northern Valley EMS or NOVA
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All providers in Coplay, PA · Land Ambulance in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.