Active NPI
Longwood Fire Company
- Land Ambulance
- Kennett Square, PA
National Provider Identifier
1023045481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 01200
- Legal business name
- LONGWOOD FIRE COMPANY
- Practice address
- 1001 E Baltimore Pike
Kennett Square, PA 19348-2301 - Phone
- (717) 464-0724
- NPI assigned
- Jun 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel C Roth
- Title
- Billing
- Phone
- (717) 464-0724
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 01200 | PA | Primary |
Addresses
Primary practice location
1001 E Baltimore Pike
Kennett Square, PA 19348-2301
Mailing address
1001 E Baltimore Pike
Kennett Square, PA 19348-2301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015490680006 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051213000464 | PA | Part B Supplier - Ambulance Service Supplier | 3678594033 | Practice locations: Kennett SQ, PA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0984612 | Longwood Fire Company | Certificate of waiver | Mar 25, 2027 |
National Provider Directory
National Provider DirectoryLocations
1001 E Baltimore Pike
Kennett Square, PA 19348
Phone (610) 388-0515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1351036800000",
"number": "1023045481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 E BALTIMORE PIKE",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193482301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 E BALTIMORE PIKE",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193482301",
"telephone_number": "717-464-0724"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGWOOD FIRE COMPANY",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-28",
"last_updated": "2012-10-24",
"status": "A",
"authorized_official_last_name": "ROTH",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "BILLING",
"authorized_official_telephone_number": "717-464-0724"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PA",
"license": "01200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015490680006",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kennett Square, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.