MEDICARE: DOROTHY VOLUNTEER FIRE COMPANY INC

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	341600000X	Ambulance	0113007	NJ

General Provider Information

NPI Number	:	1104319706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOROTHY VOLUNTEER FIRE COMPANY INC

Provider Business Mailing Address
First Line	:	PO BOX 227
Second Line	:
City	:	DOROTHY
State	:	NJ
Zip	:	08317-0227
Country	:	US
Telephone Number	:	609-992-7805
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 TUCKAHOE RD
Second Line	:
City	:	DOROTHY
State	:	NJ
Zip	:	08317-9703
Country	:	US
Telephone Number	:	609-992-7805
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	JESSE HAND
Credential	:
Telephone Number	:	609-992-7805

Provider Enumeration Date	:	06/08/2018
Last Update Date	:	06/08/2018

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