Provider Demographics
NPI:1366569873
Name:GALLITZIN AREA AMBULANCE SERVICE INC.
Entity type:Organization
Organization Name:GALLITZIN AREA AMBULANCE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:BEERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-886-5541
Mailing Address - Street 1:110 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GALLITZIN
Mailing Address - State:PA
Mailing Address - Zip Code:16641-1002
Mailing Address - Country:US
Mailing Address - Phone:814-886-5541
Mailing Address - Fax:814-886-9542
Practice Address - Street 1:110 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GALLITZIN
Practice Address - State:PA
Practice Address - Zip Code:16641-1002
Practice Address - Country:US
Practice Address - Phone:814-886-5541
Practice Address - Fax:814-886-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04080341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1040622OtherGATEWAY
PA286559OtherBLUE CROSS
PA590007288OtherUNITED HEALTHCARE
PA0008847390003Medicaid
PA590007288OtherRAILROAD MEDICARE
PA0008847390003Medicaid