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Organization

DORRANCE TOWNSHIP VOLUNTEER FIRE DEPT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFF KOTARSKY EMT (AMBULANCE CHIEF)
(570) 868-5357
Entity
Organization

Contact information

Practice address
402 SAINT JOHNS RD, WAPWALLOPEN, PA 18660-1627
(570) 868-5357
(570) 868-3488
Mailing address
PO BOX 207, ALLENTOWN, PA 18105-0207
(484) 664-2007

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04171
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015842810002
PA
01
0876834
AETNA USHC BLUE BELL HMO
01
290999
BC BS OF PA BLUE SHIELD
01
800577
FIRST PRIORITY HEALTH
01
833908
UMWA HEALTH & RETIREMENT
01
P037811
TRI CARE MID ATL
01
PA43015
PHS HEALTH PLAN HMO MDC
Enumeration date
09/23/2005
Last updated
11/09/2011
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