Provider Demographics
NPI:1023013034
Name:BLADENSBURG VOLUNTEER FIRE DEPARTMENT & RESCUE
Entity Type:Organization
Organization Name:BLADENSBURG VOLUNTEER FIRE DEPARTMENT & RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUENZLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-864-4415
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-0726
Mailing Address - Country:US
Mailing Address - Phone:717-214-6018
Mailing Address - Fax:717-214-6020
Practice Address - Street 1:4213 EDMONSTON RD
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1230
Practice Address - Country:US
Practice Address - Phone:301-864-4415
Practice Address - Fax:301-779-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403967000Medicaid
MD403967000Medicaid