Organization
FLEETWOOD VOL FIRE CO 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANA NOLL (DIRECTOR OF EMS)
(610) 944-7676
Entity
Organization
Contact information
Practice address
16 N CHESTNUT ST, FLEETWOOD, PA 19522-1227
(610) 944-7676
(610) 944-7612
Mailing address
PO BOX 94, ELVERSON, PA 19520-0094
(610) 944-7676
(610) 944-7612
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
05060
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018754110002
—
PA
01
—
0433013000
INDEPENDENCE BLUE CROSS
PA
01
—
218385
HIGHMARK BLUE SHIELD
PA
Enumeration date
02/21/2007
Last updated
06/21/2018
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