Charlestown Fire Company Inc
Organization Active NPI Land Ambulance · Charlestown, MD
NPI 1063508455 · NPPES record last updated Dec 18, 2024
Key facts
- NPI
- 1063508455
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- CHARLESTOWN FIRE COMPANY INC
- Practice address
- 307 Market St
Charlestown, MD 21914-1106 - Phone
- (023) 737-4254
- Fax
- (410) 287-7281
- NPI assigned
- Oct 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Jordan Heverin
- Title
- Captain
- Phone
- (443) 256-8492
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120723000319 | MD | Part B Supplier - Ambulance Service Supplier | 3678739513 | Practice locations: Charlestown, MD |
National Provider Directory
- Tax ID family
- Charlestown Fire Company Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | |||
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
307 Market St
Charlestown, MD 21914-1106
Mailing address
409 Porter Ave
Scottdale, PA 15683-1141
Phone (724) 887-6822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 462451300 | Medicaid | MD |
Other providers in Charlestown, MD
All providers in Charlestown, MD · Land Ambulance in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.