Provider Demographics
NPI:1194798082
Name:VOLUNTEER MEDICAL SERVICE CORPS OF LANSDALE
Entity type:Organization
Organization Name:VOLUNTEER MEDICAL SERVICE CORPS OF LANSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-855-3779
Mailing Address - Street 1:175 MEDICAL CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1260
Mailing Address - Country:US
Mailing Address - Phone:215-855-3779
Mailing Address - Fax:215-368-9512
Practice Address - Street 1:175 MEDICAL CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1260
Practice Address - Country:US
Practice Address - Phone:215-855-3779
Practice Address - Fax:215-368-9512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA460273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007173650003Medicaid
PA0007173650003Medicaid