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General NPI Number Information
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NPI Number | 1215639679
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Entity Type | Organization
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Legal Business Name | PORT GIBSON VOLUNTEER FIRE DEPARTMENT INC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 2939 GREIG ST
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City | PORT GIBSON
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State | NY
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Zip | 14537-9707
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Country | US
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Telephone | 315-331-1028
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Fax | 315-331-3588
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Provider Business Mailing Address
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Address Line | PO BOX 115
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City | PORT GIBSON
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State | NY
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Zip | 14537-0115
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Country | US
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Telephone | 315-277-0700
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Fax |
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Authorized Official
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Title or Position | EMS CAPTAIN
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Name | MRS. DAWN D WOOD
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Credential |
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Telephone | 315-277-0700
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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 |
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