=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811168131
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEMORIAL VOLUNTEER FIRE COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2008
-----------------------------------------------------
Last Update Date | 10/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 359 BAY AVENUE
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19963-4910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-422-8888
-----------------------------------------------------
Fax | 302-422-5944
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 W COMMONS BLVD SUITE 210 SUITE 210
-----------------------------------------------------
City | NEW CASTLE
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19720-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-456-5725
-----------------------------------------------------
Fax | 888-456-3155
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FIRE CHIEF
-----------------------------------------------------
Name | DONALD KENT GLASCO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 302-542-0012
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 3781
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------