Organization
WATER WITCH FIRE COMPANY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE L TOME SR. (AMBULANCE CHIEF)
(410) 378-4223
Entity
Organization
Contact information
Practice address
15 N MAIN ST, PORT DEPOSIT, MD 21904-1209
(410) 378-4223
(410) 378-9343
Mailing address
PO BOX 324, PORT DEPOSIT, MD 21904-0324
(410) 378-4223
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
389998500
—
MD
01
—
72576
HEALTH AMERICA
MD
01
—
R139
FEDERAL BLUE SHIELD
MD
01
—
Z863
CAREFIRST BLUE CROSS
MD
Enumeration date
12/18/2006
Last updated
11/11/2011
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