Healthcare Provider Details

I. General information

NPI: 1114705282
Provider Name (Legal Business Name): DELEVAN VOLUNTEER FIRE CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 S MAIN ST
DELEVAN NY
14042-9416
US

IV. Provider business mailing address

8610 MAIN ST
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 716-492-0821
  • 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: CHRISTOPHER HAZELTINE
Title or Position: EMS CAPTAIN
Credential:
Phone: 716-492-0821