Healthcare Provider Details

I. General information

NPI: 1922148683
Provider Name (Legal Business Name): MAGNOLIA VOLUNTEER FIRE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N MAIN ST
MAGNOLIA DE
19962-4000
US

IV. Provider business mailing address

100 W. COMMONS BLVD SUITE 210
NEW CASTLE DE
19720-2400
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-5678
  • Fax: 302-224-2848
Mailing address:
  • Phone: 302-456-5725
  • Fax: 888-456-3155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3673
License Number StateDE

VIII. Authorized Official

Name: ADAM GILLESPIE
Title or Position: TREASURER
Credential:
Phone: 302-355-3260