1194825984 NPI number — UNION BRIDGE FIRE COMPANY INC

Table of content: (NPI 1194825984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194825984 NPI number — UNION BRIDGE FIRE COMPANY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNION BRIDGE FIRE COMPANY INC
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:
1194825984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 947
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-0947
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-456-4629
Provider Business Mailing Address Fax Number:
717-263-1566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 WEST LOCUST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION BRIDGE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-775-7422
Provider Business Practice Location Address Fax Number:
410-857-8775
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BURDETTE
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS CAPT
Authorized Official Telephone Number:
443-974-8719

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 742210500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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