Woodlyn Fire Company

Primary specialty

AmbulanceTaxonomy code 341600000X

License

03311 Issued in PA

Legal business name

WOODLYN FIRE COMPANY

Practice address

228 Fairview Rd
Woodlyn, PA 19094-1303

Phone

(610) 833-5338

Fax

(610) 833-2873

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Leroy Poltrock

Title

Chief

Phone

(610) 833-5338

Specialties & licenses 1

Addresses

Other identifiers 3

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

Locations

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1669473906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "WOODLYN",
            "state": "PA",
            "postal_code": "190940217",
            "telephone_number": "610-833-5338",
            "fax_number": "610-833-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 FAIRVIEW RD",
            "city": "WOODLYN",
            "state": "PA",
            "postal_code": "190941303",
            "telephone_number": "610-833-5338",
            "fax_number": "610-833-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLYN FIRE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "POLTROCK",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "610-833-5338",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "03311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012211780006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "91267",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0001462000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold M Sparkler, RPH
• Katherine Stefanatos
• Chenee Womack
• Grace Woo, D.M.D.
• Woodlyn Dentistry Group LLC
• Russell E. Young, D.D.S.
• Mary Youssef- Isaac, DDS

• Ambulance in Woodlyn, PA
• Providers in Woodlyn, PA by specialty
• Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.