Provider Demographics
NPI:1376522359
Name:BRANDYWINE HUNDRED FIRE CO. NO. 1
Entity Type:Organization
Organization Name:BRANDYWINE HUNDRED FIRE CO. NO. 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PERILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-764-4901
Mailing Address - Street 1:1006 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2530
Mailing Address - Country:US
Mailing Address - Phone:302-764-4901
Mailing Address - Fax:302-764-1267
Practice Address - Street 1:1006 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2530
Practice Address - Country:US
Practice Address - Phone:302-764-4901
Practice Address - Fax:302-764-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE293050Medicare PIN