Provider Demographics
NPI:1043331895
Name:EAST WHITELAND TOWNSHIP FIRE ASSOCIATION
Entity Type:Organization
Organization Name:EAST WHITELAND TOWNSHIP FIRE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-644-8558
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
Mailing Address - Country:US
Mailing Address - Phone:717-214-7224
Mailing Address - Fax:717-214-6020
Practice Address - Street 1:205 CONESTOGA RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1633
Practice Address - Country:US
Practice Address - Phone:610-644-8558
Practice Address - Fax:610-644-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000773416L0300X
PA052283416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014246260004Medicaid
PA0014246260004Medicaid