Healthcare Provider Details

I. General information

NPI: 1497851869
Provider Name (Legal Business Name): ELSMERE FIRE COMPANY NO. 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 KIRKWOOD HWY
WILMINGTON DE
19805-2117
US

IV. Provider business mailing address

71 OMEGA DR BUILDING D
NEWARK DE
19713-2063
US

V. Phone/Fax

Practice location:
  • Phone: 302-999-0183
  • Fax: 302-999-1721
Mailing address:
  • Phone: 302-283-3300
  • Fax: 302-283-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3534
License Number StateDE

VIII. Authorized Official

Name: KEITH WILLIAM BOWMAN
Title or Position: REP
Credential:
Phone: 302-283-3300