Provider Demographics
NPI:1164452579
Name:THE CHURCH HILL VOLUNTEER FIRE CO, INC.
Entity Type:Organization
Organization Name:THE CHURCH HILL VOLUNTEER FIRE CO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:P
Authorized Official - Last Name:MANSFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-758-6552
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21623-0066
Mailing Address - Country:US
Mailing Address - Phone:410-758-6552
Mailing Address - Fax:
Practice Address - Street 1:316 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:MD
Practice Address - Zip Code:21623-0066
Practice Address - Country:US
Practice Address - Phone:410-758-6552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD399301900Medicaid
913RMedicare PIN
MD399301900Medicaid