1093835993 NPI number — THORNHURST VOLUNTEER FIRE AND RESCUE CO

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 1093835993 NPI number — THORNHURST VOLUNTEER FIRE AND RESCUE CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THORNHURST VOLUNTEER FIRE AND RESCUE CO
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:
1093835993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 385
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POCONO LAKE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18347-0385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-842-2335
Provider Business Mailing Address Fax Number:
570-848-2671

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HC1 BOX 125
Provider Second Line Business Practice Location Address:
RIVER ROAD
Provider Business Practice Location Address City Name:
THORNHURST
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18424-9312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-842-2335
Provider Business Practice Location Address Fax Number:
570-848-2671
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RINEHIMER
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
570-460-1796

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0017975200004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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