MEDICARE: MAGNOLIA VOLUNTEER FIRE COMPANY

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	3673	DE

General Provider Information

NPI Number	:	1922148683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNOLIA VOLUNTEER FIRE COMPANY

Provider Business Mailing Address
First Line	:	100 W. COMMONS BLVD
Second Line	:	SUITE 210
City	:	NEW CASTLE
State	:	DE
Zip	:	19720-2400
Country	:	US
Telephone Number	:	302-456-5725
Fax Number	:	888-456-3155

Provider Business Practice Location Address
First Line	:	2 N MAIN ST
Second Line	:
City	:	MAGNOLIA
State	:	DE
Zip	:	19962-4000
Country	:	US
Telephone Number	:	302-224-5678
Fax Number	:	302-224-2848

Authorized Official
Title or Position	:	TREASURER
Name	:	ADAM GILLESPIE
Credential	:
Telephone Number	:	302-355-3260

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/03/2023

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