MEDICARE: DAGSBORO VOLUNTEER FIRE DEPARTMENT INC

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	341600000X	Ambulance	3448	DE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590009389	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1639152705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAGSBORO VOLUNTEER FIRE DEPARTMENT INC

Provider Business Mailing Address
First Line	:	31818 WAPLES ST
Second Line	:
City	:	DAGSBORO
State	:	DE
Zip	:	19939-0128
Country	:	US
Telephone Number	:	302-732-9673
Fax Number	:	302-732-1091

Provider Business Practice Location Address
First Line	:	31818 WAPLES ST
Second Line	:
City	:	DAGSBORO
State	:	DE
Zip	:	19939
Country	:	US
Telephone Number	:	302-732-9673
Fax Number	:	302-732-1091

Authorized Official
Title or Position	:	AMBULANCE LT
Name	:	MS. JILL BRITTINGHAM
Credential	:	EMT
Telephone Number	:	302-732-6151

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	04/11/2012

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Directions to “DAGSBORO VOLUNTEER FIRE DEPARTMENT INC ” Practice Location

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