Concordville Fire and Protective Association

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

03351 Issued in PA

Legal business name

CONCORDVILLE FIRE AND PROTECTIVE ASSOCIATION

Practice address

854 Concord Road
Concordville, PA 19331-0070

Phone

(610) 459-4749

NPI assigned

May 31, 2005

Last updated

Dec 14, 2010By 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

Mr. Daniel C Roth

Title

Billing

Phone

(717) 464-0724

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1558364950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "CONCORDVILLE",
            "state": "PA",
            "postal_code": "193310070",
            "telephone_number": "610-459-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 CONCORD ROAD",
            "city": "CONCORDVILLE",
            "state": "PA",
            "postal_code": "193310070",
            "telephone_number": "610-459-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDVILLE FIRE AND PROTECTIVE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2010-12-14",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "03351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000853797",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Bartley
• Greta Bearce
• Dedra Bradham, M.A.
• Samuel P. Cimino, DDS
• Concordville Pharmacy Inc
• Michelle Cooper, MED CCC-SLP
• Francis Joseph D'Allura, BS
• Deeya Daniel, M.S.
• John Glavicic, RPH.

• Land Ambulance in Concordville, PA
• Providers in Concordville, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.

Verify at the official NPI Registry.