Healthcare Provider Details

I. General information

NPI: 1043216963
Provider Name (Legal Business Name): GRANTLEY FIRE CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 09/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 VIRGINIA AVE
YORK PA
17403-3564
US

IV. Provider business mailing address

PO BOX 726
NEW CUMBERLAND PA
17070-0726
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-4112
  • Fax: 717-843-3840
Mailing address:
  • Phone: 717-214-6018
  • Fax: 717-214-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number03391
License Number StatePA

VIII. Authorized Official

Name: ZACHARY BOYER
Title or Position: CAPTAIN
Credential:
Phone: 717-843-4112