Healthcare Provider Details

I. General information

NPI: 1285789479
Provider Name (Legal Business Name): LLANERCH FIRE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W CHESTER PIKE
HAVERTOWN PA
19083-5315
US

IV. Provider business mailing address

107 W CHESTER PIKE
HAVERTOWN PA
19083-5315
US

V. Phone/Fax

Practice location:
  • Phone: 610-789-1363
  • Fax: 610-789-1081
Mailing address:
  • Phone: 610-789-1363
  • Fax: 610-789-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CAROLE LIEBLEIN
Title or Position: PRESIDENT
Credential:
Phone: 610-449-5396