Willards Volunteer Fire Co Inc
Organization Active NPI Land Ambulance · Willards, MD
NPI 1124059787 · NPPES record last updated Nov 2, 2011
Key facts
- NPI
- 1124059787
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- NONE REQUIRED (MD)
- Legal business name
- WILLARDS VOLUNTEER FIRE CO INC
- Practice address
- 7370 Main St
Willards, MD 21874-1102 - Phone
- (410) 479-4790
- Fax
- (410) 479-4793
- NPI assigned
- Jul 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Cathy L Carter
- Title
- Billing Agent
- Phone
- (410) 479-4790
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120123000231 | MD | Part B Supplier - Ambulance Service Supplier | 0547437105 | Practice locations: Willards, MD |
National Provider Directory
Locations
7370 Main St
Willards, MD 21874
Phone (410) 835-8678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | NONE REQUIRED | MD | Yes |
Addresses
Primary practice location
7370 Main St
Willards, MD 21874-1102
Mailing address
PO Box 38
Willards, MD 21874-0038
Phone (410) 479-4790
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 553310400 | Medicaid | MD |
Other providers in Willards, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2011. 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.