MEDICARE: BRICKERVILLE FIRE COMPANY NO 1

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	04082	PA

General Provider Information

NPI Number	:	1114922135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRICKERVILLE FIRE COMPANY NO 1

Provider Business Mailing Address
First Line	:	PO BOX 726
Second Line	:
City	:	NEW CUMBERLAND
State	:	PA
Zip	:	17070-0726
Country	:	US
Telephone Number	:	717-214-6018
Fax Number	:	717-214-6020

Provider Business Practice Location Address
First Line	:	10 HOPELAND RD
Second Line	:
City	:	LITITZ
State	:	PA
Zip	:	17543-9793
Country	:	US
Telephone Number	:	717-626-6711
Fax Number	:	717-626-2805

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DAVID GROFF
Credential	:
Telephone Number	:	717-626-6711

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/22/2020

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Directions to “BRICKERVILLE FIRE COMPANY NO 1 ” Practice Location

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