Healthcare Provider Details

I. General information

NPI: 1376546093
Provider Name (Legal Business Name): SECOND ALARMER'S ASSN & RESCUE SQUAD OF MONTGOMERY COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 DAVISVILLE RD
WILLOW GROVE PA
19090-3322
US

IV. Provider business mailing address

PO BOX 13
WILLOW GROVE PA
19090-0013
US

V. Phone/Fax

Practice location:
  • Phone: 215-659-1885
  • Fax: 215-659-3177
Mailing address:
  • Phone: 215-659-1885
  • Fax: 215-659-3177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number13-0025
License Number StatePA

VIII. Authorized Official

Name: MRS. RENEE LOUISE BATES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 215-659-1885