Parkside Fire Company

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

04110 Issued in PA

Legal business name

PARKSIDE FIRE COMPANY

Practice address

107 West Roland
Parkside, PA 19015

Phone

(610) 872-6136

Fax

(610) 872-6159

NPI assigned

Jan 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Catherine Edith Didomenico, EMT-P

Title

EMS Chief

Phone

(610) 872-6136

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083769327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W ROLAND RD",
            "city": "PARKSIDE",
            "state": "PA",
            "postal_code": "19015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEST ROLAND",
            "city": "PARKSIDE",
            "state": "PA",
            "postal_code": "19015",
            "telephone_number": "610-872-6136",
            "fax_number": "610-872-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE FIRE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIDOMENICO",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "EDITH",
        "authorized_official_title_or_position": "EMS CHIEF",
        "authorized_official_telephone_number": "610-872-6136",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007826680001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.