Gordonville Fire Company
Organization Active NPI Land Ambulance · Gordonville, PA
NPI 1598058513 · NPPES record last updated Jul 22, 2016
Key facts
- NPI
- 1598058513
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 06102 (PA)
- Legal business name
- GORDONVILLE FIRE COMPANY
- Practice address
- 3204 Vigilant St.
Gordonville, PA 17529 - Phone
- (717) 769-3869
- NPI assigned
- May 24, 2011
- Organization subpart
- No
Authorized official
- Name
- David Weaver
- Title
- President
- Phone
- (717) 768-3869
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120104000610 | PA | Part B Supplier - Ambulance Service Supplier | 7810163375 | Practice locations: Gordonville, PA |
National Provider Directory
Locations
3204 Vigilant St
Gordonville, PA 17529
Phone (717) 768-3869
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 06102 | PA | Yes |
Addresses
Primary practice location
3204 Vigilant St.
Gordonville, PA 17529
Mailing address
PO Box 207
Allentown, PA 18105-0207
Phone (484) 664-2007
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014882600001 | Medicaid | PA |
Other providers in Gordonville, PA
- Karlla Welch Brigatti
- Janice A Brightman
- Vincent Joseph Carson
- Jill Van Earl
- David A Fulginiti
- Gordonville Fire Company Ambulance
- Julia Goroff
- Ambur Rae Gregorio
- Integrate Therapy and Wellness Collective
- Grace Loudon Meier
All providers in Gordonville, PA · Land Ambulance in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2016. 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.