Healthcare Provider Details

I. General information

NPI: 1366480444
Provider Name (Legal Business Name): UTICA VOLUNTEER FIRE CO & RELIEF ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 ACADEMY ST
UTICA PA
16362-0083
US

IV. Provider business mailing address

409 PORTER AVE
SCOTTDALE PA
15683-1141
US

V. Phone/Fax

Practice location:
  • Phone: 814-573-1980
  • Fax: 814-425-1735
Mailing address:
  • Phone: 724-887-6822
  • Fax: 724-887-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03350
License Number StatePA

VIII. Authorized Official

Name: HOMER HOLLABAUGH
Title or Position: CAPTAIN
Credential:
Phone: 814-573-1980