1699860866 NPI number — COLLINGDALE VOLUNTEER FIRE COMPANY # 1

Table of content: (NPI 1699860866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699860866 NPI number — COLLINGDALE VOLUNTEER FIRE COMPANY # 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLLINGDALE VOLUNTEER FIRE COMPANY # 1
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699860866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 CLIFTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLINGDALE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19023-3615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-464-0724
Provider Business Mailing Address Fax Number:
717-464-9775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 CLIFTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLINGDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19023-3615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-583-3040
Provider Business Practice Location Address Fax Number:
610-583-3020
Provider Enumeration Date:
10/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HECKMAN
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CHARIMAN OF THE BOARD
Authorized Official Telephone Number:
610-583-3040

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  02017 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000137000 . This is a "PERSONAL CHOICE B C" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001182150 0005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590001654 . This is a "PALMETO GBA R.R. MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".