Healthcare Provider Details

I. General information

NPI: 1659479459
Provider Name (Legal Business Name): EAST LANSDOWNE FIRE COMPANY NO 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 LEXINGTON AVE
EAST LANSDOWNE PA
19050-2515
US

IV. Provider business mailing address

PO BOX 329
WILLOW STREET PA
17584-0329
US

V. Phone/Fax

Practice location:
  • Phone: 610-859-3110
  • Fax: 610-859-3032
Mailing address:
  • Phone: 717-464-0724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03383
License Number StatePA

VIII. Authorized Official

Name: PENNY HAYS
Title or Position: EMS CAPT
Credential:
Phone: 610-859-3110