=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467427906
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOCKESSIN FIRE COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2006
-----------------------------------------------------
Last Update Date | 01/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1225 OLD LANCASTER PIKE
-----------------------------------------------------
City | HOCKESSIN
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19707-9560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-283-3300
-----------------------------------------------------
Fax | 302-283-3321
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 71 OMEGA DR BUILDING D
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19713-2063
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-283-3300
-----------------------------------------------------
Fax | 302-283-3321
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING COORDINATOR
-----------------------------------------------------
Name | JOHN B MAYES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 302-283-3300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 1GBE4V1246F404758
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------