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General NPI Number Information
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NPI Number | 1770610859
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Entity Type | Organization
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Legal Business Name | DINGMAN TOWNSHIP VOLUNTEER FIRE DEPARTMENT INC.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 680 LOG TAVERN RD
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City | MILFORD
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State | PA
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Zip | 18337-7784
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Country | US
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Telephone | 570-686-3696
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Fax | 570-686-5617
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Provider Business Mailing Address
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Address Line | PO BOX 417
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City | GILBERTSVILLE
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State | PA
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Zip | 19525-0417
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Country | US
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Telephone | 610-705-3979
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Fax | 610-705-3955
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM MIKULAK
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Credential |
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Telephone | 570-686-3696
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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 | 05129
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License Number State | PA
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