Provider Demographics
NPI:1770561896
Name:EMLENTON AREA AMBULANCE SERVICE
Entity type:Organization
Organization Name:EMLENTON AREA AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-887-6822
Mailing Address - Street 1:409 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1141
Mailing Address - Country:US
Mailing Address - Phone:724-887-6822
Mailing Address - Fax:724-887-9440
Practice Address - Street 1:511 MAIN ST
Practice Address - Street 2:
Practice Address - City:EMLENTON
Practice Address - State:PA
Practice Address - Zip Code:16373-9305
Practice Address - Country:US
Practice Address - Phone:724-867-1191
Practice Address - Fax:724-867-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000953416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007063700005Medicaid
PA0007063700002Medicaid
PA280339OtherBLUE CROSS/BLUE SHIELD
PA0007063700002Medicaid
PA251027OtherUPMC FOR LIFE HEALTH