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Organization

SOUTH WILLIAMSPORT FIRE DEPARTMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL CUPP (PRESIDENT)
(570) 326-4167
Entity
Organization

Contact information

Practice address
573 HASTINGS ST, SOUTH WILLIAMSPORT, PA 17702-7604
(570) 326-4167
Mailing address
700 HIGH STREET, C/O WILLIAMSPORT AREA AMBULANCE SERVICE COOPERATIVE, WILLIAMSPORT, PA 17701-3109
(570) 321-2003
(570) 321-2263

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
41003
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008815300002
PA
01
803606
FIRST PRIORITY HEALTH
PA
01
998540
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
12/28/2005
Last updated
06/28/2016
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