Healthcare Provider Details

I. General information

NPI: 1861488835
Provider Name (Legal Business Name): THE COCHRANTON VOLUNTEER FIRE DEPARTMENT AND RELIEF ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 E ADAMS ST
COCHRANTON PA
16314-8603
US

IV. Provider business mailing address

PO BOX 207
ALLENTOWN PA
18105-0207
US

V. Phone/Fax

Practice location:
  • Phone: 814-425-2111
  • Fax: 814-425-1303
Mailing address:
  • Phone: 484-664-2007
  • Fax: 484-664-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number04024
License Number StatePA

VIII. Authorized Official

Name: MRS. BARBARA JANE STOCKTON
Title or Position: TREASURER
Credential:
Phone: 814-425-2111