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General NPI Number Information
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NPI Number | 1427127307
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Entity Type | Organization
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Legal Business Name | OKLAHOMA VOL FIRE DEPT #1
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 311 16TH ST
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City | NORTH APOLLO
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State | PA
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Zip | 15673-0787
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Country | US
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Telephone | 724-727-3955
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Fax | 724-727-3953
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Provider Business Mailing Address
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Address Line | PO BOX 142 130 WASHINGTON RD
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City | APOLLO
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State | PA
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Zip | 15613-0142
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Country | US
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Telephone | 724-727-3955
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Fax | 724-727-3953
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH FETTERMAN
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Credential |
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Telephone | 724-727-3952
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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 | 06051
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License Number State | PA
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