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General NPI Number Information
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NPI Number | 1790763753
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Entity Type | Organization
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Legal Business Name | LAWRENCE PARK VOLUNTEER FIRE DEPT LAWRENCE PARK
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 4102 MAIN ST
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City | ERIE
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State | PA
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Zip | 16511-1968
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Country | US
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Telephone | 814-899-4988
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Fax | 814-898-2103
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Provider Business Mailing Address
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Address Line | 4102 MAIN ST
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City | ERIE
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State | PA
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Zip | 16511-1968
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Country | US
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Telephone | 814-899-4988
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Fax | 814-898-2103
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Authorized Official
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Title or Position | DEPUTY CHIEF
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Name | RICHARD PAUL BLISS
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Credential |
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Telephone | 814-899-4988
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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 | 02163
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License Number State | PA
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