MEDICARE: MARYSVILLE FIRE CO

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	04248	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

General Provider Information

NPI Number	:	1902805344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARYSVILLE FIRE CO

Provider Business Mailing Address
First Line	:	PO BOX 726
Second Line	:
City	:	NEW CUMBERLAND
State	:	PA
Zip	:	17070-0726
Country	:	US
Telephone Number	:	717-214-6018
Fax Number	:	717-214-6020

Provider Business Practice Location Address
First Line	:	326 CAMERON ST
Second Line	:
City	:	MARYSVILLE
State	:	PA
Zip	:	17053-1309
Country	:	US
Telephone Number	:	717-957-4130
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	JOHN RICHARDS
Credential	:
Telephone Number	:	717-957-4130

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	11/08/2011

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Directions to “MARYSVILLE FIRE CO ” Practice Location

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