Clarks Summit Fire Company No 1 Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CLARKS SUMMIT FIRE COMPANY NO 1 INC

Practice address

321 Bedford St
Clarks Summit, PA 18411-1800

Phone

(570) 586-9656

Fax

(570) 587-6003

NPI assigned

Jan 29, 2007

Last updated

Jun 24, 2015By 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

David H Jenkins

Title

President

Phone

(570) 586-9656

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1720124795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX M",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184110983",
            "telephone_number": "570-586-9656",
            "fax_number": "570-587-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BEDFORD ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111800",
            "telephone_number": "570-586-9656",
            "fax_number": "570-587-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKS SUMMIT FIRE COMPANY NO 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-586-9656"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "079474",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012007210001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "590009213",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Clarks Summit, PA
• Providers in Clarks Summit, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.