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General NPI Number Information
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NPI Number | 1083769327
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Entity Type | Organization
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Legal Business Name | PARKSIDE FIRE COMPANY
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 107 WEST ROLAND
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City | PARKSIDE
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State | PA
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Zip | 19015
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Country | US
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Telephone | 610-872-6136
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Fax | 610-872-6159
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Provider Business Mailing Address
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Address Line | 107 W ROLAND RD
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City | PARKSIDE
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State | PA
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Zip | 19015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EMS CHIEF
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Name | CATHERINE EDITH DIDOMENICO
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Credential | EMT-P
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Telephone | 610-872-6136
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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 | 04110
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License Number State | PA
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