Provider Demographics
NPI:1972709608
Name:PALMYRA AMBULANCE ASSOC INC
Entity type:Organization
Organization Name:PALMYRA AMBULANCE ASSOC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-296-6302
Mailing Address - Street 1:PO BOX 18533
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-0533
Mailing Address - Country:US
Mailing Address - Phone:800-240-6365
Mailing Address - Fax:724-234-4703
Practice Address - Street 1:125 W BROAD ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NJ
Practice Address - Zip Code:08065-1626
Practice Address - Country:US
Practice Address - Phone:856-829-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJP03110333416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0134961Medicaid
NJP00435522OtherRR MEDICARE