MEDICARE: COLLINGDALE VOLUNTEER FIRE COMPANY # 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	02017	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590001654	OTHER	PA	PALMETO GBA R.R. MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000137000	OTHER	PA	PERSONAL CHOICE B C
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699860866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLINGDALE VOLUNTEER FIRE COMPANY # 1

Provider Business Mailing Address
First Line	:	510 CLIFTON AVE
Second Line	:
City	:	COLLINGDALE
State	:	PA
Zip	:	19023-3615
Country	:	US
Telephone Number	:	717-464-0724
Fax Number	:	717-464-9775

Provider Business Practice Location Address
First Line	:	510 CLIFTON AVE
Second Line	:
City	:	COLLINGDALE
State	:	PA
Zip	:	19023-3615
Country	:	US
Telephone Number	:	610-583-3040
Fax Number	:	610-583-3020

Authorized Official
Title or Position	:	CHARIMAN OF THE BOARD
Name	:	MR. THOMAS HECKMAN
Credential	:
Telephone Number	:	610-583-3040

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	05/28/2024

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Directions to “COLLINGDALE VOLUNTEER FIRE COMPANY # 1 ” Practice Location

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