=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104255694
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOUSTON VOLUNTEER FIRE COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2013
-----------------------------------------------------
Last Update Date | 04/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 157 BROAD STREET
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19954
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-422-5811
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 122
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19954-0122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-422-5811
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EMS CHAIRPERSON
-----------------------------------------------------
Name | ROBERT SCOTT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 302-422-5811
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------