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General NPI Number Information
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NPI Number | 1083878847
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Entity Type | Organization
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Legal Business Name | LAUREL VOLUNTEER FIRE DEPARTMENT #1
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 7411 CHERRY LN
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City | LAUREL
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State | MD
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Zip | 20707-5562
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Country | US
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Telephone | 301-776-3600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | LAUREL
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State | MD
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Zip | 20725-0699
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Country | US
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Telephone | 301-776-3600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CHAIRMAN OF THE BOARD
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Name | MR. LEON VICTOR WHIPPLE JR.
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Credential |
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Telephone | 301-490-3606
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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 |
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License Number State | MD
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