Organization
FAIRMOUNT TOWNSHIP VOLUNTEER FIRE CO NO 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL MAUREEN SHAW (TREASURER/AMBULANCE CAPTAIN)
(570) 477-3691
Entity
Organization
Contact information
Practice address
671 STATE ROUTE 118, SWEET VALLEY, PA 18656-2039
(570) 477-3691
Mailing address
671 STATE ROUTE 118, SWEET VALLEY, PA 18656-2039
(570) 477-3691
(570) 477-2487
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011295280003
—
PA
01
—
208085
HIGHMARK BLUE SHIELD
PA
01
—
998548
BLUE CROSS OF NEPA
PA
Enumeration date
09/06/2006
Last updated
02/19/2016
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