1861488835 NPI number — THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861488835 NPI number — THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION
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:
1861488835
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-0207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-664-2007
Provider Business Mailing Address Fax Number:
484-664-2015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 E ADAMS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COCHRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16314-8603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-425-2111
Provider Business Practice Location Address Fax Number:
814-425-1303
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
STOCKTON
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
JANE
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
814-425-2111

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  04024 , 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: 0008347910004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0589370 . This is a "AETNA USHC BLUE BELL HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590130902 . This is a "UNITED HC RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 609293700 . This is a "DEPT OF LABOR WORK COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 217128 . This is a "UPMC HEALTH PLAN COMMERIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 287231 . This is a "BCBS OF PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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