Organization
BROOKHAVEN FIRE COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ROTH (BILLING)
(717) 464-0724
Entity
Organization
Contact information
Practice address
2 CAMBRIDGE RD, SUITE 52, BROOKHAVEN, PA 19015-1712
(717) 464-0724
Mailing address
2 CAMBRIDGE RD STE 52, BROOKHAVEN, PA 19015-1712
(717) 464-0724
(717) 464-9775
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
04077
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017820840001
—
PA
01
—
P003217808
RAILROAD MEDICARE
PA
Enumeration date
07/28/2006
Last updated
09/05/2025
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