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General NPI Number Information
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NPI Number | 1336166826
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Entity Type | Organization
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Legal Business Name | GRAND VALLEY VOLUNTEER FIRE & AMBULANCE
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | PA RT 27
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City | GRAND VALLEY
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State | PA
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Zip | 16420
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Country | US
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Telephone | 814-436-7753
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Fax |
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Provider Business Mailing Address
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Address Line | RR1 BOX 9A6
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City | GRAND VALLEY
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State | PA
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Zip | 16420
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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 | AMBULANCE CHIEF TREASURER
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Name | ROBERT H MCCLELLAND
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Credential | EMTP 009075
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Telephone | 814-436-7753
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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 | 03336
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License Number State | PA
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