Organization
LAIRDSVILLE COMMUNITY VOL FIRE CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
143 SCHOOL LANE, LAIRDSVILLE, PA 17742-0034
(570) 584-2605
(570) 329-4947
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
04128
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000784448 0001
—
PA
Enumeration date
12/28/2005
Last updated
11/14/2016
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