Provider Demographics
NPI:1033202080
Name:LOWER BURRELL VOLUNTEER FIRE CO #3
Entity Type:Organization
Organization Name:LOWER BURRELL VOLUNTEER FIRE CO #3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-468-1212
Mailing Address - Street 1:3255 LEECHBURG RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-2845
Mailing Address - Country:US
Mailing Address - Phone:724-468-1212
Mailing Address - Fax:724-468-1202
Practice Address - Street 1:3255 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-2845
Practice Address - Country:US
Practice Address - Phone:724-468-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033733416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011862840003Medicaid
PA0011862840003Medicaid