Provider Demographics
NPI:1164497467
Name:MANCHESTER FIRE ENGINE & HOOK & LADDER CO NO 1
Entity Type:Organization
Organization Name:MANCHESTER FIRE ENGINE & HOOK & LADDER CO NO 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BITTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-848-5785
Mailing Address - Street 1:PO BOX 973
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-0973
Mailing Address - Country:US
Mailing Address - Phone:410-848-5785
Mailing Address - Fax:410-848-5629
Practice Address - Street 1:3209 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-1961
Practice Address - Country:US
Practice Address - Phone:302-283-3300
Practice Address - Fax:302-283-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1FDXE45F32HA21106341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD503600300Medicaid
MD913QMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER