MEDICARE: EAST LANSDOWNE 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	03383	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	590014011	OTHER	PA	RRMC

General Provider Information

NPI Number	:	1659479459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST LANSDOWNE FIRE COMPANY NO 1

Provider Business Mailing Address
First Line	:	PO BOX 329
Second Line	:
City	:	WILLOW STREET
State	:	PA
Zip	:	17584-0329
Country	:	US
Telephone Number	:	717-464-0724
Fax Number	:

Provider Business Practice Location Address
First Line	:	164 LEXINGTON AVE
Second Line	:
City	:	EAST LANSDOWNE
State	:	PA
Zip	:	19050-2515
Country	:	US
Telephone Number	:	610-859-3110
Fax Number	:	610-859-3032

Authorized Official
Title or Position	:	EMS CAPT
Name	:	PENNY HAYS
Credential	:
Telephone Number	:	610-859-3110

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	12/17/2012

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Directions to “EAST LANSDOWNE FIRE COMPANY NO 1 ” Practice Location

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