Healthcare Provider Details

I. General information

NPI: 1053018069
Provider Name (Legal Business Name): TOWN OF FREMONT VOLUNTEER FIRE DEPARTMENT NO. 1, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RT 21 AND CREAM HILL ROAD
ARKPORT NY
14807
US

IV. Provider business mailing address

8610 MAIN ST
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 607-324-4133
  • Fax:
Mailing address:
  • Phone: 716-204-3350
  • Fax: 716-247-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARY SMITH
Title or Position: CAPTAIN
Credential:
Phone: 607-324-4133