Provider Demographics
NPI:1366429920
Name:WARRIOR RUN AREA AMBULANCE
Entity type:Organization
Organization Name:WARRIOR RUN AREA AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:HESTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-538-5100
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:WATSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17777-0008
Mailing Address - Country:US
Mailing Address - Phone:570-538-5100
Mailing Address - Fax:570-538-2967
Practice Address - Street 1:1125 MAIN ST.
Practice Address - Street 2:
Practice Address - City:WATSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17777-1432
Practice Address - Country:US
Practice Address - Phone:570-538-5100
Practice Address - Fax:570-538-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040653416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012877710001Medicaid
P00217170OtherRAILROAD MEDICARE
P00217170OtherRAILROAD MEDICARE