Centerville Volunteer Fire Department and Ladies Auxilliary
Organization Active NPI Land Ambulance · Centerville, PA
NPI 1720114960 · NPPES record last updated Jun 22, 2016
Key facts
- NPI
- 1720114960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- CENTERVILLE VOLUNTEER FIRE DEPARTMENT AND LADIES AUXILLIARY
- Practice address
- 39567 Centerville Rd
Centerville, PA 16404-1125 - Phone
- (801) 581-1010
- Fax
- (814) 581-1020
- NPI assigned
- Feb 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Robbie A Watson
- Title
- Treasurer
- Phone
- (814) 581-1010
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091106000502 | PA | Part B Supplier - Ambulance Service Supplier | 0244378594 | Practice locations: Centerville, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
39567 Centerville Rd
Centerville, PA 16404-1125
Mailing address
PO Box 179
Centerville, PA 16404-0179
Phone (814) 581-1010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0013964140006 | Medicaid | PA |
Other providers in Centerville, PA
- Denise M Berlin
- Lucinda G Fosburg
- Laurel Geer
- Joseph Graybill
- Homestead Family Health & Wellness
- Lana Lyle
All providers in Centerville, 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 Jun 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.