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PENNSYLVANIA AMBULANCE LLC
NPI 1124454566
Ambulance in Dunmore, PA

Active since September 17, 2013CLIA 39D2327530 · Waiver
1000 DUNHAM DR, DUNMORE, PA 18512(570) 558-1212(570) 558-1213 Get Directions Write a Review

NPPES record last updated: September 17, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pennsylvania Ambulance Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNSYLVANIA AMBULANCE LLC (NPI 1124454566) is a healthcare organization registered as an ambulance in Dunmore, Pennsylvania and active in the NPI registry since September 2013. The organization holds a CLIA Waiver certificate valid through July 23, 2027 and lists Bruce W Beauvais, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1124454566
Entity TypeOrganization
Primary Taxonomy341600000X
Legal Business NamePENNSYLVANIA AMBULANCE LLC
Location Address1000 DUNHAM DRDunmore, PA 18512-2666
Mailing Address1000 Dunham DrDunmore, PA 18512-2666 · (570) 558-1212 · Fax (570) 558-1213
Phone(570) 558-1212
Fax(570) 558-1213
Organization SubpartNo
Authorized OfficialBruce W BeauvaisOperations Manager · (570) 558-1212
Enumeration DateSeptember 17, 2013
✔ NPI 1124454566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulanceTransportation Services
Taxonomy Code341600000X
Definition
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).
1000 DUNHAM DR, Dunmore, PA 18512
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2327530

Pennsylvania Ambulance LLC · Scranton, PA
Active · expires Jul 23, 2027
CLIA Number39D2327530
Laboratory TypeAmbulance
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorBruce Beauvais
Laboratory Phone(570) 558-1212
Laboratory LocationPennsylvania Ambulance LLC717 Capouse Ave, Scranton, PA 18509
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
39,197 services3,600 patients
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427
Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.
3,979 services2,600 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
1,856 services1,268 patients
Ambulance service, basic life support, non-emergency transport, (bls) A0428
Basic Life Support (BLS) non-emergency ambulance service provides safe transportation for patients who don't need immediate medical attention. It includes monitoring vital signs, ensuring comfort, and administering basic care during transport.
789 services606 patients
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) A0426
Ambulance Service, Advanced Life Support, Non-Emergency Transport, Level 1 (ALS 1) is a medical transportation service for patients who don't have an immediate life-threatening condition but require advanced medical monitoring or interventions during the journey.
165 services160 patients
Advanced life support, level 2 (als 2) A0433
Advanced Life Support Level 2 (ALS 2) is a medical service provided during emergencies. It involves advanced procedures like defibrillation, medication administration or endotracheal intubation by trained professionals to stabilize critical patients.
55 services55 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #01188 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #01188

DMEPOS supplier · Old Forge, PAOperated by Pennsylvania CVS Pharmacy LLC
✔

Accepts Medicare assignment

CVS Pharmacy #01188 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20342927
Medicare Participant SinceJanuary 1, 2023
Supplier Location101 S Main StOld Forge, PA 18518
Phone(570) 457-2182
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELLEN BUTASH
Registered Nurse (Emergency)
1000 DUNHAM DR
DUNMORE, PA 18512
Lackawanna County (570) 687-0589
MARY VITALE
Registered Nurse (Emergency)
1000 DUNHAM DR
DUNMORE, PA 18512
Lackawanna County (570) 687-0589
CHRISTOPHER DONOHUE MD
Emergency Medicine
1000 DUNHAM DR, EMERGENCY SERVICES
DUNMORE, PA 18512
Lackawanna County (570) 346-9193

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pennsylvania Ambulance LLC's NPI number?

The NPI number for Pennsylvania Ambulance LLC is 1124454566. It was assigned to this organization in the NPPES registry on September 17, 2013.

Where is Pennsylvania Ambulance LLC located?

Pennsylvania Ambulance LLC is located at 1000 Dunham Dr, Dunmore, PA 18512. The listed phone number is (570) 558-1212.

What is Pennsylvania Ambulance LLC's specialty?

The primary specialty registered for this NPI is Ambulance with taxonomy code 341600000X.

Does Pennsylvania Ambulance LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #01188 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Pennsylvania Ambulance LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2327530) is associated with this NPI, valid through July 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pennsylvania Ambulance LLC was last updated on September 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.