Provider Demographics
NPI:1326145624
Name:FREDERICA VOLUNTEER FIRE COMPANY
Entity Type:Organization
Organization Name:FREDERICA VOLUNTEER FIRE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-335-3235
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 1:6 FRONT STREET
Practice Address - Street 2:
Practice Address - City:FREDERICA
Practice Address - State:DE
Practice Address - Zip Code:19946
Practice Address - Country:US
Practice Address - Phone:302-456-5725
Practice Address - Fax:888-456-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE3578341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE200065205Medicaid
DE0000595315Medicaid