West Schuylkill Advanced Life Support Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

04256 Issued in PA

Legal business name

WEST SCHUYLKILL ADVANCED LIFE SUPPORT INC.

Practice address

49 North St
Tremont, PA 17981-1526

Phone

(570) 695-2500

Fax

(570) 695-3361

NPI assigned

Nov 12, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wally Hodgson

Title

President

Phone

(570) 695-2500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1131753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1740261007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 539",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170550539",
            "telephone_number": "717-938-1690",
            "fax_number": "717-938-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 NORTH ST",
            "city": "TREMONT",
            "state": "PA",
            "postal_code": "179811526",
            "telephone_number": "570-695-2500",
            "fax_number": "570-695-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SCHUYLKILL ADVANCED LIFE SUPPORT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-12",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "HODGSON",
        "authorized_official_first_name": "WALLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-695-2500"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015876400003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tina Yeagley

• Land Ambulance in Tremont, PA
• Providers in Tremont, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.