Organization Active NPI

Lower Alsace Volunteer Ambulance Association

  • Land Ambulance
  • Reading, PA
National Provider Identifier
1821122235
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
06098 Issued in PA
Legal business name
LOWER ALSACE VOLUNTEER AMBULANCE ASSOCIATION
Practice address
750 N 25TH St
Reading, PA 19606-1400
Phone
(610) 779-0190
Fax
(610) 779-9143
NPI assigned
Mar 15, 2007
Last updated
Feb 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Mrs. Carol Wentzel
Title
Operations Manager
Phone
(610) 779-0190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 06098 PA Primary

Addresses

Primary practice location

750 N 25TH St
Reading, PA 19606-1400

Mailing address

750 N 25TH St
Reading, PA 19606-1400
Phone (610) 779-0190

Other identifiers 5

IdentifierTypeStateIssuer
209088OtherPAHIGH MARK BLUE SHIELD
0093888000OtherPAINDEPENDENCE BLUE CROSS
0011361200005MedicaidPA
590010476OtherPAPALMETTO GBA MEDICARE RAI
50006179OtherPACAPITAL BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120402000126 PA Part B Supplier - Ambulance Service Supplier 7012177843 Practice locations: Reading, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2093564Lower Alsace Ambulance Association750 North 25TH Street, Reading, PA 19606Certificate of waiverMar 30, 2027

National Provider Directory

National Provider Directory

Locations

750 N 25th St
Reading, PA 19606
Phone (610) 779-0190

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1821122235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N 25TH ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196061400",
            "telephone_number": "610-779-0190",
            "fax_number": "610-779-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N 25TH ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196061400",
            "telephone_number": "610-779-0190",
            "fax_number": "610-779-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER ALSACE VOLUNTEER AMBULANCE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "WENTZEL",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "610-779-0190",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "06098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGH MARK BLUE SHIELD",
            "identifier": "209088",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0093888000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011361200005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA MEDICARE RAI",
            "identifier": "590010476",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50006179",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.