Organization
JENNERSTOWN VOLUNTEER FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERON KOONTZ (EMS COORDINATOR)
(814) 442-2243
Entity
Organization
Contact information
Practice address
1536 PITT ST, JENNERSTOWN, PA 15547-0229
(814) 629-5371
Mailing address
PO BOX 229, JENNERSTOWN, PA 15547-0229
(814) 629-5371
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04115
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014830730001
—
PA
01
—
200245
HIGHMARK
PA
01
—
590009137
RR MEDICARE
PA
Enumeration date
11/14/2006
Last updated
10/30/2023
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