Healthcare Provider Details

I. General information

NPI: 1760544589
Provider Name (Legal Business Name): JARRETTSVILLE VOLUNTEER FIRE CO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 FEDERAL HILL RD
JARRETTSVILLE MD
21084
US

IV. Provider business mailing address

PO BOX 7
JARRETTSVILLE MD
21084-0007
US

V. Phone/Fax

Practice location:
  • Phone: 410-692-7890
  • Fax:
Mailing address:
  • Phone: 410-692-7890
  • 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: JAMES A BAIR
Title or Position: PRESIDENT
Credential:
Phone: 410-692-7890