Active NPI
Nemacolin Volunteer Fire Co.
- Land Ambulance
- Nemacolin, PA
National Provider Identifier
1881687952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 04106
- Legal business name
- NEMACOLIN VOLUNTEER FIRE CO.
- Practice address
- 441 Roosevelt LN
Nemacolin, PA 15351-1025 - Phone
- (724) 966-7459
- Fax
- (724) 966-7409
- NPI assigned
- Aug 24, 2005
- Last updated
- Dec 8, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Max Brozik Sr.
- Title
- Commander
- Phone
- (724) 966-7459
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 04106 | PA | Primary |
Addresses
Primary practice location
441 Roosevelt LN
Nemacolin, PA 15351-1025
Mailing address
409 Porter Ave
Scottdale, PA 15683-1141
Phone (724) 887-6822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008923100006 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120127000553 | PA | Part B Supplier - Ambulance Service Supplier | 4789851072 | Practice locations: Nemacolin, PA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1670457600000",
"number": "1881687952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 PORTER AVE",
"city": "SCOTTDALE",
"state": "PA",
"postal_code": "156831141",
"telephone_number": "724-887-6822",
"fax_number": "724-887-9440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 ROOSEVELT LN",
"city": "NEMACOLIN",
"state": "PA",
"postal_code": "153511025",
"telephone_number": "724-966-7459",
"fax_number": "724-966-7409"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEMACOLIN VOLUNTEER FIRE CO.",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-24",
"last_updated": "2022-12-08",
"certification_date": "2022-12-08",
"status": "A",
"authorized_official_last_name": "BROZIK",
"authorized_official_first_name": "MAX",
"authorized_official_title_or_position": "COMMANDER",
"authorized_official_telephone_number": "724-966-7459",
"authorized_official_name_suffix": "Sr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "PA",
"license": "04106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008923100006",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nemacolin, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.