Nanticoke Community Ambulance

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

NANTICOKE COMMUNITY AMBULANCE

Practice address

901 S Hanover St
Nanticoke, PA 18634-3107

Phone

(570) 735-5201

NPI assigned

Dec 6, 2006

Last updated

Apr 25, 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

Bernard J Norieka

Title

President

Phone

(570) 735-5201

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1891854840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S HANOVER ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343107",
            "telephone_number": "570-735-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S HANOVER ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343107",
            "telephone_number": "570-735-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANTICOKE COMMUNITY AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "NORIEKA",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-735-5201"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "077655",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012655480006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "899989",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Michalik
• David Peter Mouallem, DO
• Casey Shannon Mulligan, PA-C
• Jenna Mundenar
• Bruno Brian Najaka IV, PHARM.D.
• Nanticoke Counseling Services PC
• Nanticoke Hospital Company LLC (Special Care Hospital)
• Nanticoke Hospital Company LLC (Special Care Hospital)
• Nanticoke Medical Center LLC
• Nanticoke Rehabilitation and Healthcare LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.