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NPI Code Detail

MEDICARE: LAWRENCE PARK VOLUNTEER FIRE DEPT LAWRENCE PARK

MEDICARE: LAWRENCE PARK VOLUNTEER FIRE DEPT LAWRENCE PARK
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
13416L0300XLand Ambulance02163PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790763753
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWRENCE PARK VOLUNTEER FIRE DEPT LAWRENCE PARK
Provider Business Mailing Address
First Line : 4102 MAIN ST
Second Line :
City : ERIE
State : PA
Zip : 16511-1968
Country : US
Telephone Number : 814-899-4988
Fax Number : 814-898-2103
Provider Business Practice Location Address
First Line : 4102 MAIN ST
Second Line :
City : ERIE
State : PA
Zip : 16511-1968
Country : US
Telephone Number : 814-899-4988
Fax Number : 814-898-2103
Authorized Official
Title or Position : DEPUTY CHIEF
Name : RICHARD PAUL BLISS
Credential :
Telephone Number : 814-899-4988
Provider Enumeration Date : 01/09/2006
Last Update Date : 12/06/2023

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Directions to “LAWRENCE PARK VOLUNTEER FIRE DEPT LAWRENCE PARK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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