Healthcare Provider Details

I. General information

NPI: 1891938148
Provider Name (Legal Business Name): FRUITLAND VOLUNTEER FIRE COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W MAIN ST
FRUITLAND MD
21826-1663
US

IV. Provider business mailing address

PO BOX 558
DENTON MD
21629-0558
US

V. Phone/Fax

Practice location:
  • Phone: 410-479-4790
  • Fax:
Mailing address:
  • Phone: 410-479-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: CATHY LYNN CARTER
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 410-479-4790