Indian Head Volunteer Fire Dept and Rescue Squad, Inc.
Organization Active NPI Land Ambulance · Indian Head, MD
NPI 1619640604 · NPPES record last updated Jul 27, 2021
Key facts
- NPI
- 1619640604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- INDIAN HEAD VOLUNTEER FIRE DEPT AND RESCUE SQUAD, INC.
- Practice address
- 4095 Indian Head Hwy
Indian Head, MD 20640-1781 - Phone
- (301) 743-3900
- NPI assigned
- Jul 27, 2021
- Organization subpart
- No
Authorized official
- Name
- Leah Carter Watkins
- 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 |
|---|---|---|---|---|
| O20210917002922 | MD | Part B Supplier - Ambulance Service Supplier | 3870990815 | Practice locations: Indian Head, MD |
National Provider Directory
Locations
4095 Indian Head Hwy
Indian Head, MD 20640
Phone (301) 743-3900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
4095 Indian Head Hwy
Indian Head, MD 20640-1781
Mailing address
PO Box 535
Denton, MD 21629-0535
Phone (410) 479-4790
Other providers in Indian Head, MD
- Benjamin Graves
- Dale R Harman
- David Paul Horvath
- Ijeoma Igwe
- Indian Head Pharmacy Inc
- Channel James
- Surnita Lawon Jefferson-Jones
- Sherry Teresa Johnson
- Carllisa Roshea Jordan
- Memuna Kamara
All providers in Indian Head, MD · Land Ambulance in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2021. 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.