1861488835 NPI number — THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION

Table of content: (NPI 1861488835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861488835 NPI number — THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION
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:
1861488835
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-0207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-664-2007
Provider Business Mailing Address Fax Number:
484-664-2015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 E ADAMS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COCHRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16314-8603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-425-2111
Provider Business Practice Location Address Fax Number:
814-425-1303
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
STOCKTON
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
JANE
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
814-425-2111

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  04024 , 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: 0008347910004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0589370 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590130902 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 609293700 . This is a "DEPT OF LABOR WORK COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 217128 . This is a "UPMC HEALTH PLAN COMMERIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 287231 . This is a "BCBS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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