1841242856 NPI number — WINDBER FIRE COMPANY NO 1

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841242856 NPI number — WINDBER FIRE COMPANY NO 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINDBER FIRE COMPANY NO 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:
NORTHERN EMS
Provider Other Organization Name Type Code:
3
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:
1841242856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 816
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15907-0816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-536-9951
Provider Business Mailing Address Fax Number:
814-536-9952

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1620 SOMERSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDBER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15963-1748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-467-9244
Provider Business Practice Location Address Fax Number:
814-467-6796
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CICON
Authorized Official First Name:
AARON
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
814-467-9244

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  00310 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , with the licence number: 03325 , 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: 080022400 . This is a "BLACK LUNG PROGRAM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1832951 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590014073 . This is a "PALMETTO GBA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0018329510002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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