Provider Demographics
NPI:1841272770
Name:HOLLIDAYSBURG AMERICAN LEGION HALA INC
Entity type:Organization
Organization Name:HOLLIDAYSBURG AMERICAN LEGION HALA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-695-1421
Mailing Address - Street 1:801 SCOTCH VALLEY RD
Mailing Address - Street 2:PO BOX 461
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-9693
Mailing Address - Country:US
Mailing Address - Phone:814-695-1421
Mailing Address - Fax:814-695-8280
Practice Address - Street 1:801 SCOTCH VALLEY RD
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-9693
Practice Address - Country:US
Practice Address - Phone:814-695-1421
Practice Address - Fax:814-695-8280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02235341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF21559075691OtherION
PA1019983OtherGATEWAY
PA201256OtherUPMC HEALTHCARE
PA0012782320002Medicaid
PA30507OtherGEISINGER HEATHPLAN
PA441590268OtherPALMENTO GSA
PA30507OtherGEISINGER HEATHPLAN