Provider Demographics
NPI:1124194352
Name:NEW KENSINGTON VOLUNTEER FIRE DEPARTMENT AMBULANCE CORPS
Entity Type:Organization
Organization Name:NEW KENSINGTON VOLUNTEER FIRE DEPARTMENT AMBULANCE CORPS
Other - Org Name:NEW KENSINGTON VOLUNTEER FIRE DEPARTMENT AMBULANCE CORPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRUMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-335-0790
Mailing Address - Street 1:839 ANDERSON STREET
Mailing Address - Street 2:PO BOX 126
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068
Mailing Address - Country:US
Mailing Address - Phone:724-335-0790
Mailing Address - Fax:724-335-7907
Practice Address - Street 1:839 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6029
Practice Address - Country:US
Practice Address - Phone:724-335-0790
Practice Address - Fax:724-335-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA06040146L00000X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA281165Medicare ID - Type Unspecified