Organization
NEWPORT TOWNSHIP FIREMEN'S COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P. FLORYSHAK (PRESIDENT)
(570) 735-4652
Entity
Organization
Contact information
Practice address
1002 CENTER ST., NANTICOKE, PA 18634-1904
(570) 735-4652
(570) 735-4652
Mailing address
1002 CENTER ST., NANTICOKE, PA 18634-1904
(570) 735-4652
(570) 735-4652
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833937
FEDERAL BLACK LUNG
—
01
—
P036777
CHAMPVA
—
Enumeration date
12/06/2006
Last updated
08/19/2011
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