1114041985 NPI number — S M VAUCLAIN FIRE COMPANY

Table of content: (NPI 1114041985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114041985 NPI number — S M VAUCLAIN FIRE COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
S M VAUCLAIN FIRE COMPANY
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:
1114041985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 329
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOW STREET
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17584-0329
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:
1201 HAVERFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRUM LYNNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19022-1106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-833-2533
Provider Business Practice Location Address Fax Number:
610-532-9911
Provider Enumeration Date:
03/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BYRNE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
610-833-2523

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  01311 , 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: 00012293720001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590015217 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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