Provider Demographics
NPI:1225133804
Name:HOLLOWAY TERRACE VOLUNTEER FIRE COMPANY NO 1
Entity Type:Organization
Organization Name:HOLLOWAY TERRACE VOLUNTEER FIRE COMPANY NO 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:302-654-2817
Mailing Address - Street 1:100 W COMMONS BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2400
Mailing Address - Country:US
Mailing Address - Phone:302-456-5725
Mailing Address - Fax:888-456-3155
Practice Address - Street 1:700 WEST AVE
Practice Address - Street 2:MANOR BRANCH
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-6200
Practice Address - Country:US
Practice Address - Phone:302-654-2817
Practice Address - Fax:302-654-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE3605341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000601815Medicaid
DE235779Medicare PIN