Provider Demographics
NPI:1194949081
Name:SENECA AMRAMP
Entity type:Organization
Organization Name:SENECA AMRAMP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-677-7001
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-0254
Mailing Address - Country:US
Mailing Address - Phone:814-677-7001
Mailing Address - Fax:814-678-3373
Practice Address - Street 1:177 COUNTRY LN
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-3301
Practice Address - Country:US
Practice Address - Phone:814-677-7001
Practice Address - Fax:814-678-3373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1018459700001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018459700001OtherWAIVER PUBLIC WELFARE