MEDICARE: EAST BUTLER VOLUNTEER FIRE CO & RELIEF ASSOCIATION

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	02232	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194814723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST BUTLER VOLUNTEER FIRE CO & RELIEF ASSOCIATION

Provider Business Mailing Address
First Line	:	808 GRANT AVE
Second Line	:
City	:	EAST BUTLER
State	:	PA
Zip	:	16029-0162
Country	:	US
Telephone Number	:	724-468-1212
Fax Number	:	724-468-1204

Provider Business Practice Location Address
First Line	:	808 GRANT AVE
Second Line	:
City	:	EAST BUTLER
State	:	PA
Zip	:	16029-0162
Country	:	US
Telephone Number	:	724-468-1212
Fax Number	:	724-468-1204

Authorized Official
Title or Position	:	COO
Name	:	KEVIN HESIDENZ
Credential	:
Telephone Number	:	724-468-1212

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	09/19/2012

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Directions to “EAST BUTLER VOLUNTEER FIRE CO & RELIEF ASSOCIATION ” Practice Location

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