Organization
JORDAN VOLUNTEER FIRE COMPANY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L FIETTA (PRESIDENT)
(315) 689-3923
Entity
Organization
Contact information
Practice address
1 NORTH HAMILTON ST, JORDAN, NY 13080
(315) 689-3923
Mailing address
1 NORTH HAMILTON ST, JORDAN, NY 13080
(315) 689-3923
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
09841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01201692
—
NY
01
—
956671
MVP
—
01
—
9697180
GHI
—
01
—
P00042649
RAILROAD MEDICARE
—
Enumeration date
12/06/2005
Last updated
11/19/2007
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