1508159724 NPI number — MUNCY AREA VOLUNTEER FIRE COMPANY INC

Table of content: JULIE ANN KRAMER CRNP (NPI 1689469512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508159724 NPI number — MUNCY AREA VOLUNTEER FIRE COMPANY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUNCY AREA VOLUNTEER 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:
1508159724
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNCY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17756-1306
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-546-3000
Provider Business Mailing Address Fax Number:
570-546-3307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNCY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17756-1306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-546-3000
Provider Business Practice Location Address Fax Number:
570-546-3307
Provider Enumeration Date:
05/20/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GIRVEN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
L
Authorized Official Title or Position:
TRUSTEE
Authorized Official Telephone Number:
570-546-5740

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 280952 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1026483300001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 078400 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".