Provider Demographics
NPI:1346286572
Name:PULASKI TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:PULASKI TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEASURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-510-1998
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-0207
Mailing Address - Country:US
Mailing Address - Phone:484-664-2007
Mailing Address - Fax:484-664-2015
Practice Address - Street 1:3535 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:PA
Practice Address - Zip Code:16143
Practice Address - Country:US
Practice Address - Phone:724-510-1998
Practice Address - Fax:724-964-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02221341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010279020001Medicaid
PA0010279020001Medicaid