Organization
OKLAHOMA VOL FIRE DEPT #1
Active
Organization
OKLAHOMA VOL FIRE DEPT #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH FETTERMAN (PRESIDENT)
(724) 727-3952
Entity
Organization
Contact information
Practice address
311 16TH ST, NORTH APOLLO, PA 15673-0787
(724) 727-3955
(724) 727-3953
Mailing address
PO BOX 142, 130 WASHINGTON RD, APOLLO, PA 15613-0142
(724) 727-3955
(724) 727-3953
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
06051
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007007420001
—
PA
01
—
05088311
AETNA US HEALTHCARE
—
05
—
1018626
—
PA
01
—
292043
HIGHMARK
—
05
—
66979
—
PA
01
—
803266
BLACK LUNG
—
01
—
8122
HEALTH AMERICA
—
01
—
V0V212
UPMC
—
Enumeration date
11/07/2006
Last updated
08/22/2020
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