Organization
CLINTON TOWNSHIP VOLUNTEER FIRE CO. NO. 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
2311 RT 54 HWY, MONTGOMERY, PA 17752-9433
(570) 547-1000
(570) 547-6017
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
05100
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019473140002
—
PA
01
—
P00018390
RAILROAD MEDICARE
—
Enumeration date
10/11/2005
Last updated
09/04/2008
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