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General NPI Number Information
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NPI Number | 1689751174
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Entity Type | Organization
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Legal Business Name | RIVERSIDE VOL. FIRE DEPT.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 615 LIBERTY AVE
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City | JOHNSTOWN
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State | PA
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Zip | 15905-3609
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Country | US
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Telephone | 814-288-1100
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Fax | 814-487-7137
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Provider Business Mailing Address
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Address Line | 615 LIBERTY AVE
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City | JOHNSTOWN
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State | PA
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Zip | 15905-3609
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Country | US
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Telephone | 814-288-1100
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Fax | 814-487-7137
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. JAY DANIELS
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Credential |
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Telephone | 814-288-1076
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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 | 1103433
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License Number State | PA
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