# WEST SIDE VOLUNTEER FIRE DEPARTMENT INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386669521
- **Authorized official:** CATHY LYNN CARTER (BILLING AGENT)
- **Authorized official phone:** 41047974790

## Contact information

- **Practice address:** 21045 NANTICOKE RD, BIVALVE, MD 21814-2041
- **Practice address phone:** (410) 479-4790
- **Practice address fax:** (410) 479-4793
- **Mailing address:** PO BOX 557, DENTON, MD 21629-0557
- **Mailing address phone:** (410) 479-4790
- **Mailing address fax:** (410) 479-4793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 02/01/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 402010300 | — | MD |