MEDICARE: VOLUNTEER FIRE COMPANY NO 1 OF CHESAPEAKE CITY INCORPORATED

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

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	G650	OTHER	MD	CAREFIRST BC/BS

General Provider Information

NPI Number	:	1770681645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLUNTEER FIRE COMPANY NO 1 OF CHESAPEAKE CITY INCORPORATED

Provider Business Mailing Address
First Line	:	215 LOCK ST
Second Line	:
City	:	CHESAPEAKE CITY
State	:	MD
Zip	:	21915-1013
Country	:	US
Telephone Number	:	410-885-5951
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 LOCK ST
Second Line	:
City	:	CHESAPEAKE CITY
State	:	MD
Zip	:	21915-1013
Country	:	US
Telephone Number	:	410-885-5951
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	EDWARD L LONG SR.
Credential	:
Telephone Number	:	410-885-5951

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	03/26/2013

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