NPIMap

Organization Active NPI

Mahoning Valley Ambulance Association

  • Land Ambulance
  • Lehighton, PA
National Provider Identifier
1801883228
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
04213 Issued in PA
Legal business name
MAHONING VALLEY AMBULANCE ASSOCIATION
Practice address
902 Mill Rd
Lehighton, PA 18235-9667
Phone
(570) 386-2518
Fax
(570) 386-3268
NPI assigned
Sep 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Mr. Robert Walter Miller Jr.
Title
Treasurer
Phone
(570) 386-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 04213 PA Primary

Addresses

Primary practice location

902 Mill Rd
Lehighton, PA 18235-9667

Mailing address

PO Box 207
Allentown, PA 18105-0207
Phone (800) 473-2278

Other identifiers 16

IdentifierTypeStateIssuer
0930709OtherAETNA USHC BLUE BELL HMO
281283OtherBC BS OF PA BLUE SHIELD
812110OtherFIRST PRIORITY HEALTH
0012008100001MedicaidPA
281283OtherSIGNATURE 65 2NDRY ONLY
281283OtherCLASSIC BLUE MAJMED ZAH Z
281283OtherDIRECT BLUE ZAB
281283OtherPPO BLUE ZAR
281283OtherMEDIGAP BLUE 2NDRY ONLY
281283OtherSELECT BLUE HMO
281283OtherCLASSIC BLUE ZAH
281283OtherFEDERAL BC BS
281283OtherSPECIAL CARE SOC MISS BC
441590544OtherUNITED HC RR MEDICARE
1144160OtherKEYSTON MERCY HMO DPA
833808OtherUMWA HEALTH & RETIREMENT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080926000438 PA Part B Supplier - Ambulance Service Supplier 7618044090 Practice locations: Lehighton, PA

National Provider Directory

National Provider Directory
Tax ID family
Mahoning Valley Ambulance Association2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

397 Hemlock Dr
Lehighton, PA 18235
Phone (570) 386-5522

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1801883228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181050207",
            "telephone_number": "800-473-2278",
            "fax_number": "484-664-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 MILL RD",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182359667",
            "telephone_number": "570-386-2518",
            "fax_number": "570-386-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHONING VALLEY AMBULANCE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "570-386-5800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC BLUE BELL HMO",
            "identifier": "0930709",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF PA BLUE SHIELD",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "812110",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012008100001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIGNATURE 65 2NDRY ONLY",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASSIC BLUE MAJMED ZAH Z",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIRECT BLUE ZAB",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO BLUE ZAR",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIGAP BLUE 2NDRY ONLY",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT BLUE HMO",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASSIC BLUE ZAH",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC BS",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIAL CARE SOC MISS BC",
            "identifier": "281283",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC RR MEDICARE",
            "identifier": "441590544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTON MERCY HMO DPA",
            "identifier": "1144160",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA HEALTH & RETIREMENT",
            "identifier": "833808",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehighton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.