MEDICARE: PLEASANT HALL VOLUNTEER FIRE CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	04249	PA

General Provider Information

NPI Number	:	1104194695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT HALL VOLUNTEER FIRE CO

Provider Business Mailing Address
First Line	:	PO BOX 726
Second Line	:
City	:	NEW CUMBERLAND
State	:	PA
Zip	:	17070-0726
Country	:	US
Telephone Number	:	717-532-5155
Fax Number	:	717-532-5840

Provider Business Practice Location Address
First Line	:	9722 CUMBERLAND HIGHWAY
Second Line	:
City	:	PLEASANT HALL
State	:	PA
Zip	:	17246-0115
Country	:	US
Telephone Number	:	717-532-5155
Fax Number	:	717-532-5840

Authorized Official
Title or Position	:	BOARD SECRETARY
Name	:	MR. TERESA A WOLFE
Credential	:
Telephone Number	:	717-532-5155

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	12/12/2011

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