Provider Demographics
NPI:1376694075
Name:BRADY TOWNSHIP VOLUNTEER FIRE RESCUE & AMBULANCE CO INC
Entity Type:Organization
Organization Name:BRADY TOWNSHIP VOLUNTEER FIRE RESCUE & AMBULANCE CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:FOLMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-583-7610
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:LUTHERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15848-0157
Mailing Address - Country:US
Mailing Address - Phone:814-583-7610
Mailing Address - Fax:814-583-5336
Practice Address - Street 1:11 COMMUNITY CENTER ST
Practice Address - Street 2:
Practice Address - City:LUTHERSBURG
Practice Address - State:PA
Practice Address - Zip Code:15848
Practice Address - Country:US
Practice Address - Phone:814-583-7610
Practice Address - Fax:814-583-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023705130001Medicaid
PA1023705130001Medicaid
P00875381Medicare PIN