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General NPI Number Information
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NPI Number | 1821029455
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Entity Type | Organization
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Legal Business Name | GOODWILL FIRE COMPANY INCORPORATED
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 212 BROADWAY
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City | CENTREVILLE
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State | MD
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Zip | 21617-1008
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Country | US
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Telephone | 410-758-1422
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Fax | 410-758-3528
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Provider Business Mailing Address
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Address Line | PO BOX 659
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City | CENTREVILLE
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State | MD
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Zip | 21617-0659
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Country | US
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Telephone | 410-758-1422
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Fax | 410-758-3528
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Authorized Official
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Title or Position | CHIEF
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Name | THOMAS H PALMATARY JR.
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Credential |
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Telephone | 410-758-1422
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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 |
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License Number State |
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