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  7. NPI Record 1760581292

PALMERTON COMMUNITY AMBULANCE ASSOCIATION, INC.
Complete NPI Record 1760581292
Ambulance - Land Transport in Palmerton, PA

NPI Status: Active since September 21, 2006

Contact Information

501 DELAWARE AVENUE
PALMERTON, PA
ZIP 18071
Phone: (610) 826-7609
Fax: (610) 826-5327

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Second Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Business Practice Location Address Fax Number
  20. Provider Enumeration Date
  21. Last Update Date
  22. Authorized Official Last Name
  23. Authorized Official First Name
  24. Authorized Official Middle Name
  25. Authorized Official Title or Position
  26. Authorized Official Telephone Number
  27. Healthcare Provider Taxonomy Code 1
  28. Provider License Number 1
  29. Provider License Number State Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Healthcare Provider Taxonomy Code 2
  32. Provider License Number 2
  33. Provider License Number State Code 2
  34. Healthcare Provider Primary Taxonomy Switch 2
  35. Other Provider Identifier 1
  36. Other Provider Identifier Type Code 1
  37. Other Provider Identifier State 1
  38. Other Provider Identifier 2
  39. Other Provider Identifier Type Code 2
  40. Other Provider Identifier State 2
  41. Other Provider Identifier Issuer 2
  42. Other Provider Identifier 3
  43. Other Provider Identifier Type Code 3
  44. Other Provider Identifier State 3
  45. Other Provider Identifier Issuer 3
  46. Other Provider Identifier 4
  47. Other Provider Identifier Type Code 4
  48. Other Provider Identifier Issuer 4
  49. Other Provider Identifier 5
  50. Other Provider Identifier Type Code 5
  51. Other Provider Identifier State 5
  52. Other Provider Identifier Issuer 5
  53. Other Provider Identifier 6
  54. Other Provider Identifier Type Code 6
  55. Other Provider Identifier State 6
  56. Other Provider Identifier Issuer 6
  57. Other Provider Identifier 7
  58. Other Provider Identifier Type Code 7
  59. Other Provider Identifier State 7
  60. Other Provider Identifier Issuer 7
  61. Other Provider Identifier 8
  62. Other Provider Identifier Type Code 8
  63. Other Provider Identifier State 8
  64. Other Provider Identifier Issuer 8
  65. Other Provider Identifier 9
  66. Other Provider Identifier Type Code 9
  67. Other Provider Identifier State 9
  68. Other Provider Identifier Issuer 9
  69. Other Provider Identifier 10
  70. Other Provider Identifier Type Code 10
  71. Other Provider Identifier State 10
  72. Other Provider Identifier Issuer 10
  73. Other Provider Identifier 11
  74. Other Provider Identifier Type Code 11
  75. Other Provider Identifier State 11
  76. Other Provider Identifier Issuer 11
  77. Other Provider Identifier 12
  78. Other Provider Identifier Type Code 12
  79. Other Provider Identifier State 12
  80. Other Provider Identifier Issuer 12
  81. Other Provider Identifier 13
  82. Other Provider Identifier Type Code 13
  83. Other Provider Identifier State 13
  84. Other Provider Identifier Issuer 13
  85. Other Provider Identifier 14
  86. Other Provider Identifier Type Code 14
  87. Other Provider Identifier Issuer 14
  88. Other Provider Identifier 15
  89. Other Provider Identifier Type Code 15
  90. Other Provider Identifier State 15
  91. Other Provider Identifier Issuer 15
  92. Other Provider Identifier 16
  93. Other Provider Identifier Type Code 16
  94. Other Provider Identifier State 16
  95. Other Provider Identifier Issuer 16
  96. Is Organization Subpart
  97. Authorized Official Name Prefix Text

Complete NPI Dataset

This page represents the complete record for NPI 1760581292. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1760581292
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: PO BOX 2
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: 501 DELAWARE AVENUE
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: PALMERTON
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: PA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 18071
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 6108267809
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 6108265327
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 501 DELAWARE AVENUE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: PALMERTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: PA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 180710002
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6108267609
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 6108265327
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 9/21/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/28/2012
The date that a record was last updated or changed.
Authorized Official Last Name: WEAVER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DANIELLE
The first name of the authorized official.
Authorized Official Middle Name: T.
The middle name of the authorized official.
Authorized Official Title or Position: FINANCIAL OFFICER/BOARD OF DIRECTOR
The title or position of the authorized official.
Authorized Official Telephone Number: 5704011279
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 3416L0300X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 06111
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: PA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 3416L0300X
Provider License Number 2: 06111PA
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: PA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: Y
Other Provider Identifier 1: 0007807340001
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: PA
Other Provider Identifier 2: 0145827
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: TN
Other Provider Identifier Issuer 2: BC OF TENN
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Other Provider Identifier 3: 1528003
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: NY
Other Provider Identifier Issuer 3: GATEWAY
Other Provider Identifier 4: 2709438
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 4: OXFORD
The State code in the location of the provider being identified.
Other Provider Identifier 5: 1154979
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Other Provider Identifier Type Code 5: 01
The country code in the location address of the provider being identified.
Other Provider Identifier State 5: PA
Other Provider Identifier Issuer 5: KEYSTONE MERCY
Other Provider Identifier 6: 127702
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: PA
Other Provider Identifier Issuer 6: UNISON MED PLUS
Other Provider Identifier 7: 50002800
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: PA
Other Provider Identifier Issuer 7: CAP. BC
Other Provider Identifier 8: 0025427000
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: PA
Other Provider Identifier Issuer 8: PERSONAL CHOICE
Other Provider Identifier 9: 20012758
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: PA
Other Provider Identifier Issuer 9: AMERIHEALTH MERCY
Other Provider Identifier 10: 808539
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: PA
Other Provider Identifier Issuer 10: FIRST PRIOITY
Other Provider Identifier 11: 284951
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: PA
Other Provider Identifier Issuer 11: HIGHMARK BS
Other Provider Identifier 12: 74817
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: PA
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Other Provider Identifier Issuer 12: ATHEM BLUE
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Other Provider Identifier 13: 002542700
Other Provider Identifier Type Code 13: 01
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 13: PA
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 13: AMERIHEALTH
Other Provider Identifier 14: 31245
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Other Provider Identifier Type Code 14: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 14: HEALTH PARTNERS
Other Provider Identifier 15: 590007582
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 15: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 15: PA
Other Provider Identifier Issuer 15: RR MED
Other Provider Identifier 16: 0780734/01
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 16: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 16: PA
Other Provider Identifier Issuer 16: MED PLUS
Is Organization Subpart: N
Authorized Official Name Prefix Text: MRS.