1871564393 NPI number — MT PLEASANT TWP VOL FIRE DEPT NO 1

Table of content: (NPI 1871564393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871564393 NPI number — MT PLEASANT TWP VOL FIRE DEPT NO 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MT PLEASANT TWP VOL FIRE DEPT 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:
Provider Other Organization Name Type Code:
6
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:
1871564393
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 PORTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTDALE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15683-1141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-887-6822
Provider Business Mailing Address Fax Number:
724-887-9440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5123 WATER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-2554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-423-1829
Provider Business Practice Location Address Fax Number:
724-423-5011
Provider Enumeration Date:
02/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRICK
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT CHIEF
Authorized Official Telephone Number:
724-757-6823

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  01125 , 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: 0011863000002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com