# JOPPA MAGNOLIA VOLUNTEER FIRE CO. INC.

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

## Provider details

- **NPI number:** 1689785974
- **Authorized official:** MR. ROBERT W RUSSELL (PRESIDENT)
- **Authorized official phone:** (410) 679-1055

## Contact information

- **Practice address:** 1403 OLD MOUNTAIN ROAD S, JOPPA, MD 21085-3103
- **Practice address phone:** (410) 679-1055
- **Practice address fax:** (410) 679-3420
- **Mailing address:** 1403 OLD MOUNTAIN ROAD S, JOPPA, MD 21085-3103
- **Mailing address phone:** (410) 679-1055
- **Mailing address fax:** (410) 679-3420

## Taxonomy

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

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 11/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 590008873 | RAILROAD MEDICARE PIN | MD |
| 05 | — | 914550800 | — | MD |
| 01 | — | T413 | FEDERAL BLUE SHIELD | MD |
| 01 | — | Y938 | CAREFIRST BLUE CROSS/BLUE SHIELD | MD |