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General NPI Number Information
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NPI Number | 1831198878
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Entity Type | Organization
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Legal Business Name | WISSINOMING VOLUNTEER FIRST AID CORPORATION INC
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 6179 HEGERMAN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19135-3711
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Country | US
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Telephone | 215-624-8511
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Fax | 215-332-1241
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Provider Business Mailing Address
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Address Line | 6179 HEGERMAN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19135-3711
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Country | US
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Telephone | 215-624-8511
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Fax | 215-332-1241
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH ANTHONY DICICCO
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Credential |
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Telephone | 215-624-8511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 01256
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License Number State | PA
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