BLACKLICK VALLEY FOUNDATION AND AMBULANCE SERVICE INC (NPI# 1033173828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033173828 |
| Entity Type | Organization |
| Organization Name | BLACKLICK VALLEY FOUNDATION AND AMBULANCE SERVICE INC |
| Practice Address |
1077 1st St Nanty Glo PA 15943-1159 |
| Practice Telephone | 8147497332 |
| Practice Fax Number | 8147497188 |
| Mailing Telephone | 8147497332 |
| Mailing Fax Number | 8147497188 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2012-12-07 |
| Authorized Official Name | BEVERLY SHERWOOD-BURNS (PRESIDENT) |
| Authorized Official Telephone | 8147497332 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
03150 | PA | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | RAILROAD MEDICARE | 590001284 | 01 |
| PA | 0008930680001 | 05 | |
| PA | PA BLUE SHIELD | 281902 | 01 |
| Street Address |
1077 1ST ST |
| City | NANTY GLO |
| State | PA |
| Zip Code | 15943-1159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861024390 | Daniel James Leonard IIi | General Practice | 397 Fifth Street, Nanty Glo, PA 15943 | 2020-02-12 |
| 1235539800 | Mainline Pharmacy Ebensburg, LLC | Counselor | 1049 Shoemaker St, Nanty Glo, PA 15943 | 2014-09-02 |
| 1750495354 | Blacklick Valley School District | Local Education Agency (LEA) | 555 Birch St, Nanty Glo, PA 15943-1060 | 2006-08-19 |
| 1396263463 | Alternative Community Resource Program, Inc. | Community/Behavioral Health | 555 Birch St, Nanty Glo, PA 15943-1060 | 2017-09-08 |
| 1477977692 | Christopher Zamboni | Specialist/Technologist | 555 Birch St, Nanty Glo, PA 15943-1060 | 2014-02-07 |
| 1679014047 | Megan Joy Beiler | Social Worker | 1510 Mohawk Cir, Nanty Glo, PA 15943-1163 | 2017-03-17 |
| 1548253669 | Daniel W Johnson | Family Medicine | 1060 Lloyd St, Nanty Glo, PA 15943-1232 | 2005-08-24 |
| 1023475944 | Lisa Janosik | Nurse Practitioner | 1060 Lloyd St, Nanty Glo, PA 15943-1232 | 2016-01-22 |
| 1003222134 | Dlp Conemaugh Physician Practices LLC | Family Medicine | 1060 Lloyd St, Nanty Glo, PA 15943-1232 | 2014-07-09 |
| 1861519985 | Michaeleen N Wilson | Family Medicine | 1060 Lloyd St, Nanty Glo, PA 15943-1232 | 2007-03-23 |
| Find all providers in zip 15943 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.