Provider Demographics
NPI:1073651667
Name:FAIRVIEW FIRE AND RESCUE
Entity Type:Organization
Organization Name:FAIRVIEW FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUBROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-474-5091
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-0069
Mailing Address - Country:US
Mailing Address - Phone:814-474-5091
Mailing Address - Fax:814-474-5093
Practice Address - Street 1:7190 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-2027
Practice Address - Country:US
Practice Address - Phone:814-474-5091
Practice Address - Fax:814-474-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-03
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011569190003Medicaid
PA280448OtherHIGHMARK BLUE SHIELD
590001822Medicare PIN
PA0011569190003Medicaid