1821244310 NPI number — WILLIAMSPORT VOLUNTEER FIRE AND EMERGENCY MEDICAL SERVICES, INC.

Table of content: (NPI 1821244310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821244310 NPI number — WILLIAMSPORT VOLUNTEER FIRE AND EMERGENCY MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAMSPORT VOLUNTEER FIRE AND EMERGENCY MEDICAL SERVICES, 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:
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:
1821244310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
892 NEW CASTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SLIPPERY ROCK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16057-4228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-280-5974
Provider Business Mailing Address Fax Number:
800-280-5974

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 BRANDY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSPORT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21795-1558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-479-4790
Provider Business Practice Location Address Fax Number:
410-479-4793
Provider Enumeration Date:
08/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BINGAMAN
Authorized Official First Name:
DONNIE
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
301-223-9500

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: 416119000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00702079 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 142697 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".




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