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General NPI Number Information
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NPI Number | 1962422550
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Entity Type | Organization
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Legal Business Name | FELLOWS CLUB VOLUNTEER FIRE DEPT
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 1015 STRAWBERRY ALLEY
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City | CONNEAUTVILLE
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State | PA
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Zip | 16406
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Country | US
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Telephone | 814-587-2876
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 305
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City | CONNEAUTVILLE
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State | PA
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Zip | 16406-0305
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Country | US
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Telephone | 814-587-2876
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Fax |
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Authorized Official
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Title or Position | TREASURER/AMBULANCE CHIEF
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Name | GERALD F CARLESS
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Credential |
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Telephone | 814-587-2876
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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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