Oklahoma Volunteer Fire Dept
Organization Active NPI Land Ambulance · Vangergrift, PA
NPI 1932272416 · NPPES record last updated Oct 23, 2018
Key facts
- NPI
- 1932272416
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 06051 (PA)
- Legal business name
- OKLAHOMA VOLUNTEER FIRE DEPT
- Practice address
- 700 Holland Street
Vangergrift, PA 15690-1444 - Phone
- (724) 568-3864
- Fax
- (724) 794-1633
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- James M Caporali
- Title
- Business Manager
- Phone
- (724) 568-3864
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101213000502 | PA | Part B Supplier - Ambulance Service Supplier | 5698962959 | Practice locations: Apollo, PA |
National Provider Directory
- Tax ID family
- Oklahoma Vol Fire Dept 1
Locations
130 N Washington Rd
Apollo, PA 15613
Phone (724) 567-6121
171 Thorn St
Apollo, PA 15613
Phone (724) 568-3864
200 Thorn St
Apollo, PA 15613
235 Longfellow St
Vandergrift, PA 15690
Phone (724) 568-5551
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 06051 | PA | Yes |
| Land Ambulance | 3416L0300X |
Addresses
Primary practice location
700 Holland Street
Vangergrift, PA 15690-1444
Mailing address
700 Holland Street
Vangergrift, PA 15690-1444
Phone (724) 568-3864
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05088311 | Other | AETNA US HEALTHCARE | |
| 8122 | Other | HEALTH AMERICA | |
| 0007007420005 | Medicaid | PA | |
| 283162 | Other | HIGHMARK | |
| 66979 | Medicaid | PA | |
| V0V212 | Other | UPMC HEALTH PLAN | |
| 1018626 | Medicaid | PA | |
| 0007007420001 | Medicaid | PA | |
| 803266 | Other | BLACK LUNG |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.