Pocono Mountain Regional Emergency Medical Services, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

POCONO MOUNTAIN REGIONAL EMERGENCY MEDICAL SERVICES, INC

Practice address

135 Tegawitha Rd
Tobyhanna, PA 18466-7796

Phone

(570) 839-8485

Fax

(570) 839-0777

NPI assigned

Oct 18, 2005

Last updated

Feb 5, 2016By 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

Denise Doremus

Title

Operations Manager

Phone

(570) 350-0029

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1861481269",
    "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": "484-664-2007",
            "fax_number": "484-664-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 TEGAWITHA RD",
            "city": "TOBYHANNA",
            "state": "PA",
            "postal_code": "184667796",
            "telephone_number": "570-839-8485",
            "fax_number": "570-839-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO MOUNTAIN REGIONAL EMERGENCY MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "DOREMUS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "570-350-0029"
    },
    "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": "816393",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORK COMP",
            "identifier": "359501200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY HMO DPA",
            "identifier": "20035568",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCNE CONTRACT CLAIMS",
            "identifier": "816393",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019454900001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC OF NE PA",
            "identifier": "1446752",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001945900003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Douglas Owen
• Tina Pack
• Pamela J. Olson LCSW, Caadc
• Pennsylvania Autism Action Center
• Pocono Mountain Charter School
• Pocono Podiatry Associates
• Taj Arnae Polen, CPR & AED, FIRST AID
• Karen Powell, CRNP
• Leslie D Prescott, LMT
• John Rafferty, CRNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.