Provider Demographics
NPI:1427089085
Name:SHARPSBURG AREA EMERGENCY MEDICAL SERVICE INC
Entity type:Organization
Organization Name:SHARPSBURG AREA EMERGENCY MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-479-4790
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21782-0307
Mailing Address - Country:US
Mailing Address - Phone:410-479-4790
Mailing Address - Fax:410-479-4793
Practice Address - Street 1:110 1/2 W CHAPLINE ST
Practice Address - Street 2:
Practice Address - City:SHARPSBURG
Practice Address - State:MD
Practice Address - Zip Code:21782
Practice Address - Country:US
Practice Address - Phone:410-479-4790
Practice Address - Fax:410-479-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD183818100Medicaid
MD183818100Medicaid
590005029Medicare PIN