Healthcare Provider Details

I. General information

NPI: 1780752691
Provider Name (Legal Business Name): GREENFIELD TWP. VOL. FIRE CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 ROUTE 106
GREENFIELD TOWNSHIP PA
18407-3904
US

IV. Provider business mailing address

424 ROUTE 106
GREENFIELD TOWNSHIP PA
18407-3904
US

V. Phone/Fax

Practice location:
  • Phone: 570-282-4981
  • Fax:
Mailing address:
  • Phone: 570-282-5652
  • Fax: 570-282-5653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number02140
License Number StatePA

VIII. Authorized Official

Name: MR. RICHARD W WHITELAVICH
Title or Position: EMS CAPTAIN
Credential:
Phone: 570-282-4981