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General NPI Number Information
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NPI Number | 1083602114
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Entity Type | Organization
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Legal Business Name | LAKE MEADE FIRE & RESCUE INC
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 492 LAKE MEADE DR
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City | EAST BERLIN
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State | PA
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Zip | 17316-9345
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Country | US
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Telephone | 717-259-8338
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 207
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City | ALLENTOWN
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State | PA
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Zip | 18105-0207
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Country | US
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Telephone | 484-664-2007
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Fax |
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Authorized Official
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Title or Position | TRUSTEE ASSISTANT CHIEF
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Name | JULIE BRANDT
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Credential |
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Telephone | 717-259-8338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 03130
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License Number State | PA
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