Active NPI
Lackawanna Ambulance, Inc
- Ambulance
- Scranton, PA
National Provider Identifier
1720187966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 04164
- Legal business name
- LACKAWANNA AMBULANCE, INC
- Practice address
- 1000 Remington Ave
Scranton, PA 18505-1118 - Phone
- (570) 207-5200
- Fax
- (570) 207-5266
- NPI assigned
- Sep 22, 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. Richard Sean Buckman
- Title
- President Ceo
- Phone
- (570) 207-5200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 04164 | PA | Primary |
Addresses
Primary practice location
1000 Remington Ave
Scranton, PA 18505-1118
Mailing address
1000 Remington Ave
Scranton, PA 18505-1118
Phone (570) 207-5200
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0077296000 | Other | PA | INDEPENDENCE BC ID |
| 02635725 | Medicaid | NY | |
| 35511 | Other | PA | HEALTH PARTNERS ID |
| 080017000 | Other | PA | FEDERAL BLACK LUNG ID |
| 206068 | Other | PA | FEDERAL BCBS ID |
| 4076133 00 | Medicaid | MD | |
| 998575 | Other | PA | BLUE CROSS NEPA |
| 359796600 | Other | PA | OWCP ID |
| 807228 | Other | PA | FIRST PRIORITY |
| 1007506200003 | Medicaid | PA | |
| 000000096978 | Other | PA | THREE RIVERS HLTH PLN |
| 1539617 | Other | PA | GATEWAY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1285718400000",
"number": "1720187966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 REMINGTON AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185051118",
"telephone_number": "570-207-5200",
"fax_number": "570-207-5266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 REMINGTON AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185051118",
"telephone_number": "570-207-5200",
"fax_number": "570-207-5266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LACKAWANNA AMBULANCE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-22",
"last_updated": "2010-09-29",
"status": "A",
"authorized_official_last_name": "BUCKMAN",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "SEAN",
"authorized_official_title_or_position": "PRESIDENT CEO",
"authorized_official_telephone_number": "570-207-5200",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "PA",
"license": "04164",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BC ID",
"identifier": "0077296000",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02635725",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS ID",
"identifier": "35511",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLACK LUNG ID",
"identifier": "080017000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BCBS ID",
"identifier": "206068",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4076133 00",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS NEPA",
"identifier": "998575",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OWCP ID",
"identifier": "359796600",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY",
"identifier": "807228",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007506200003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS HLTH PLN",
"identifier": "000000096978",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1539617",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
- Linda M Kushner, AU.D.
- John Anthony Kutz, M.D.
- Sherill Rivera Kwiatkowski, RN
- Ervin Leigh Labrador, CRNA
- Kelle Lach, CRNP
- Lackawanna Emergency Group PC
- Lackawanna Medical Group PC
- Lackawanna Surgery Center LLC
- Lackawanna Valley Dermatology Associates Limited
- Lackawanna/Susquehanna Office of Drug and Alcohol Programs
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.