1356420046 NPI number — CITIZENS VOLUNTEER HOSE CO NO 1 OF BIRDVILLE PA

Table of content: (NPI 1356420046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356420046 NPI number — CITIZENS VOLUNTEER HOSE CO NO 1 OF BIRDVILLE PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITIZENS VOLUNTEER HOSE CO NO 1 OF BIRDVILLE PA
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:
1356420046
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
965 BURTNER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATRONA HEIGHTS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15065-2300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-224-1912
Provider Business Mailing Address Fax Number:
724-224-2791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
965 BURTNER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATRONA HEIGHTS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15065-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-224-1912
Provider Business Practice Location Address Fax Number:
724-224-2791
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ERB
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W
Authorized Official Title or Position:
EMS SUPERVISOR
Authorized Official Telephone Number:
724-224-1912

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  05208 , 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: 75183 . This is a "UNISON HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1005486 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0010771090002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: V0V25B . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0074629 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 281468 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".




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