MEDICARE: WISSINOMING VOLUNTEER FIRST AID CORPORATION 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	01256	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	:	1831198878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISSINOMING VOLUNTEER FIRST AID CORPORATION INC

Provider Business Mailing Address
First Line	:	6179 HEGERMAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-3711
Country	:	US
Telephone Number	:	215-624-8511
Fax Number	:	215-332-1241

Provider Business Practice Location Address
First Line	:	6179 HEGERMAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-3711
Country	:	US
Telephone Number	:	215-624-8511
Fax Number	:	215-332-1241

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH ANTHONY DICICCO
Credential	:
Telephone Number	:	215-624-8511

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	02/20/2013

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