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General NPI Number Information
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NPI Number | 1104823871
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Entity Type | Organization
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Legal Business Name | RALSTON VOLUNTEER FIRE COMPANY INC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 10970 RT 14
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City | RALSTON
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State | PA
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Zip | 17763-0001
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Country | US
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Telephone | 570-995-5555
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Fax | 570-995-9118
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | RALSTON
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State | PA
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Zip | 17763-0001
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Country | US
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Telephone | 570-995-5555
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Fax | 570-995-9118
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Authorized Official
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Title or Position | SECRETARY, AMBULANCE CAPTAIN
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Name | MRS. TAWNY L DIETRICK
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Credential | EMT-P
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Telephone | 570-995-5555
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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 | 03159
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License Number State | PA
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