# WATER WITCH FIRE COMPANY INC

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

## Provider details

- **NPI number:** 1619030038
- **Authorized official:** WAYNE L TOME SR. (AMBULANCE CHIEF)
- **Authorized official phone:** (410) 378-4223

## Contact information

- **Practice address:** 15 N MAIN ST, PORT DEPOSIT, MD 21904-1209
- **Practice address phone:** (410) 378-4223
- **Practice address fax:** (410) 378-9343
- **Mailing address:** PO BOX 324, PORT DEPOSIT, MD 21904-0324
- **Mailing address phone:** (410) 378-4223

## Taxonomy

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

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 11/11/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 389998500 | — | MD |
| 01 | — | 72576 | HEALTH AMERICA | MD |
| 01 | — | R139 | FEDERAL BLUE SHIELD | MD |
| 01 | — | Z863 | CAREFIRST BLUE CROSS | MD |