Provider Demographics
NPI:1588767552
Name:CAMBRIDGE AREA VOLUNTEER AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:CAMBRIDGE AREA VOLUNTEER AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-398-4116
Mailing Address - Street 1:202 VENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16403-1040
Mailing Address - Country:US
Mailing Address - Phone:814-398-4116
Mailing Address - Fax:
Practice Address - Street 1:202 VENANGO AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:16403-1040
Practice Address - Country:US
Practice Address - Phone:814-398-4116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006998750004Medicaid
PA138735OtherHEALTH AMERICA
PA138735OtherHEALTH AMERICA
PA0006998750004Medicaid