Organization
MEDIA FIRE AND HOOK AND LADDER COMPANY #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN RACHKO (ACTING CAPTAIN)
(610) 565-3738
Entity
Organization
Contact information
Practice address
11 S JACKSON ST, MEDIA, PA 19063-2913
(610) 565-3738
Mailing address
11 S JACKSON ST, MEDIA, PA 19063-2913
(610) 565-3738
(610) 565-8980
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
15017
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022535800001
—
PA
01
—
P00068150
RAILROAD MEDICARE
PA
Enumeration date
06/04/2006
Last updated
09/23/2016
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