Healthcare Provider Details

I. General information

NPI: 1215917828
Provider Name (Legal Business Name): FIRE DEPARTMENT OF NORTH VERSAILLES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 BROAD ST
NORTH VERSAILLES PA
15137-2101
US

IV. Provider business mailing address

PO BOX 220
NORTH VERSAILLES PA
15137-0220
US

V. Phone/Fax

Practice location:
  • Phone: 412-829-7378
  • Fax: 412-200-5615
Mailing address:
  • Phone: 412-829-7378
  • Fax: 412-200-5615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03077
License Number StatePA

VIII. Authorized Official

Name: RYAN MARTON
Title or Position: EMS DIRECTOR
Credential:
Phone: 412-829-7378