Provider Demographics
NPI:1346395597
Name:GALENA VOLUNTEER FIRE CO INC
Entity Type:Organization
Organization Name:GALENA VOLUNTEER FIRE CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:SR
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:410-648-5050
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:MD
Mailing Address - Zip Code:21635-0189
Mailing Address - Country:US
Mailing Address - Phone:410-648-5050
Mailing Address - Fax:410-648-5267
Practice Address - Street 1:90 EAST CROSS STREET
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:MD
Practice Address - Zip Code:21635
Practice Address - Country:US
Practice Address - Phone:410-648-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0148360146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD450QMedicare PIN