| Organization Name: | BROCKWAY AREA AMBULANCE SERVICE, INC |
| NPI Number: | 1174605455 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA WORK (PRESIDENT OF BOARD) |
| Mailing Address: | 1147 Cherry St Brockway |
| State: | PA US |
| Postal Code: | 158241627 |
| Phone Number: | 8142651212 |
| Fax Number: | 8142658898 |
| NPI Enumeration Date: | 10/19/2006 |
| NPI Last Update Date: | 03/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 05125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |