Fairmount Township Volunteer Fire Co No 1

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

FAIRMOUNT TOWNSHIP VOLUNTEER FIRE CO NO 1

Practice address

671 State Route 118
Sweet Valley, PA 18656-2039

Phone

(570) 477-3691

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Jill Maureen Shaw

Title

Treasurer/Ambulance Captain

Phone

(570) 477-3691

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1487757449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 STATE ROUTE 118",
            "city": "SWEET VALLEY",
            "state": "PA",
            "postal_code": "186562039",
            "telephone_number": "570-477-3691",
            "fax_number": "570-477-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 STATE ROUTE 118",
            "city": "SWEET VALLEY",
            "state": "PA",
            "postal_code": "186562039",
            "telephone_number": "570-477-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT TOWNSHIP VOLUNTEER FIRE CO NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MAUREEN",
        "authorized_official_title_or_position": "TREASURER/AMBULANCE CAPTAIN",
        "authorized_official_telephone_number": "570-477-3691"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "208085",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011295280003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NEPA",
            "identifier": "998548",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen M Buerger Talacka, DC
• Sharon Marie Clark, LPC
• Fultz Family Chiropractic LLC
• David Christopher Fultz, DC
• Functional Connections, LLC
• James a Kliamovich II
• Stephanie Jean Jones

• Land Ambulance in Sweet Valley, PA
• Providers in Sweet Valley, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.