Organization
MILMONT FIRE CO 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY D JACKSON EMT (AMBULANCE CAPTAIN)
(610) 532-3232
Entity
Organization
Contact information
Practice address
714 BELMONT AVE, FOLSOM, PA 19033-3503
(610) 532-3232
(610) 532-4733
Mailing address
PO BOX 42973, PHILADELPHIA, PA 19101
(610) 532-9444
(610) 532-9911
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
PA044704
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016403260001
—
PA
01
—
1417093154
RAILROAD MEDICARE
PA
Enumeration date
01/29/2007
Last updated
05/13/2010
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