Community Ambulance Service Club

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

04141 Issued in PA

Legal business name

COMMUNITY AMBULANCE SERVICE CLUB

Practice address

633 East Colliery Avenue
Tower City, PA 17980

Phone

(717) 943-8013

Fax

(717) 647-2546

NPI assigned

Feb 26, 2007

Last updated

Sep 15, 2015By 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

Mr. Jeremiah A Deiter

Title

President

Phone

(717) 943-8013

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Tower Porter Community Ambulance Service Former legal business name

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

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1962538900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "city": "TOWER CITY",
            "state": "PA",
            "postal_code": "179800033",
            "telephone_number": "717-647-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 EAST COLLIERY AVENUE",
            "city": "TOWER CITY",
            "state": "PA",
            "postal_code": "17980",
            "telephone_number": "717-943-8013",
            "fax_number": "717-647-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY AMBULANCE SERVICE CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "DEITER",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-943-8013",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590007322",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012143980004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50004678",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "0130130",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE SENIOR BLUE",
            "identifier": "50004678",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG PROGRAM",
            "identifier": "893120",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20018661",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tower Porter Community Ambulance Service",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Melissa C Amershek
• Alysha Marie Balonis, LPC
• Jessica Lynn Bova, M.S.,CCC-SLP
• Joel James Digris, M.S.P.T
• Paul Clay Dimon, OPTICIAN
• Elsie J. Wenrich (Leslie W Wenrich Associates)
• Janelle D. Kilmer, M.S., CCC-SLP
• Julie Letcher, RPH

• Land Ambulance in Tower City, PA
• Providers in Tower City, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.