| Organization Name: | PINE GROVE COMMUNITY AMBULANCE ASSOCIATION |
| NPI Number: | 1023147931 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID T. LUKASEWICZ (PRESIDENT) |
| Mailing Address: | 46 Spruce Street Pine Grove |
| State: | PA US |
| Postal Code: | 179631715 |
| Phone Number: | 5703453004 |
| Fax Number: | 5703456621 |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 07/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |