MEDICARE: HOBBIE VOLUNTEER FIRE COMPANY #1

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	04159	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	:	1952320186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOBBIE VOLUNTEER FIRE COMPANY #1

Provider Business Mailing Address
First Line	:	610 BIRCH RD
Second Line	:
City	:	WAPWALLOPEN
State	:	PA
Zip	:	18660-2037
Country	:	US
Telephone Number	:	570-379-3013
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 BIRCH RD
Second Line	:
City	:	WAPWALLOPEN
State	:	PA
Zip	:	18660-2037
Country	:	US
Telephone Number	:	570-379-3013
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EILEEN M SMITH
Credential	:
Telephone Number	:	570-379-3013

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	05/22/2008

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