Lake Winola Fire Company No 1

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LAKE WINOLA FIRE COMPANY NO 1

Practice address

1204 Sr 307
Factoryville, PA 18419-7880

Phone

(570) 378-2000

Fax

(570) 378-3763

NPI assigned

Mar 15, 2007

Last updated

Nov 15, 2024By 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

Daniel Williams

Title

Vice President

Phone

(570) 378-2000

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1609900588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73",
            "city": "LAKE WINOLA",
            "state": "PA",
            "postal_code": "186250073",
            "telephone_number": "570-378-2000",
            "fax_number": "570-378-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 SR 307",
            "city": "FACTORYVILLE",
            "state": "PA",
            "postal_code": "184197880",
            "telephone_number": "570-378-2000",
            "fax_number": "570-378-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WINOLA FIRE COMPANY NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "570-378-2000"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011580290002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.