Provider Demographics
NPI:1033168216
Name:MILLCREEK FIRE COMPANY
Entity Type:Organization
Organization Name:MILLCREEK FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-283-3300
Mailing Address - Street 1:3900 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5110
Mailing Address - Country:US
Mailing Address - Phone:302-998-8911
Mailing Address - Fax:302-998-8342
Practice Address - Street 1:71 OMEGA DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2063
Practice Address - Country:US
Practice Address - Phone:302-283-3300
Practice Address - Fax:302-283-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1GBKC34D7WF051182341600000X
DE1GBC4F1103F509247341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000644015Medicaid
DE201303Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER